Provider Demographics
NPI:1871668731
Name:NEW ENGLAND DENTAL CENTER
Entity type:Organization
Organization Name:NEW ENGLAND DENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:S
Authorized Official - Last Name:FURMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:860-688-3663
Mailing Address - Street 1:250 LAMBERTON RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-2129
Mailing Address - Country:US
Mailing Address - Phone:860-688-3663
Mailing Address - Fax:860-688-2111
Practice Address - Street 1:250 LAMBERTON RD
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-2129
Practice Address - Country:US
Practice Address - Phone:860-688-3663
Practice Address - Fax:860-688-2111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT75301223G0001X
CT53241223S0112X
CT68801223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1871668731OtherNPI