Provider Demographics
NPI:1619343621
Name:THOMASTON FAMILY DENTAL, LLC
Entity Type:Organization
Organization Name:THOMASTON FAMILY DENTAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MANPUNEET
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:347-307-6691
Mailing Address - Street 1:131 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06787-1747
Mailing Address - Country:US
Mailing Address - Phone:860-283-9700
Mailing Address - Fax:
Practice Address - Street 1:131 MAIN ST
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:CT
Practice Address - Zip Code:06787-1747
Practice Address - Country:US
Practice Address - Phone:860-283-9700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-12
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty