Provider Demographics
NPI:1760905830
Name:BH DENTAL LLC
Entity Type:Organization
Organization Name:BH DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUEYOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:646-645-1598
Mailing Address - Street 1:194 BUCKLAND HILLS DR STE 1076
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06042-8785
Mailing Address - Country:US
Mailing Address - Phone:860-644-0099
Mailing Address - Fax:
Practice Address - Street 1:194 BUCKLAND HILLS DR STE 1076
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06042-8785
Practice Address - Country:US
Practice Address - Phone:860-644-0099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT010439261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental