Avon Village Family Dentistry
LBN: Avon Village Family Dentistry
Avon Village Family Dentistry is an health care organization with primary practice located at 32 East Main Street , Avon CT 06001-1039. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Suppliers / Customized Equipment. Dental Providers / General Practice is the primary health care specialty.
Avon Village Family Dentistry can be contacted via phone (860) 678-1140, or through Mentasti, Lauren M via phone (860) 678-1140.
Contact Information
Primary practice address
32 East Main Street
Avon CT 06001-1039
Phone: (860) 678-1140
Fax: (860) 284-4423
Website:
Authorized official contact:
Name: Mentasti, Lauren M Doctor of Dental Medicine (DMD)
Phone: (860) 678-1140
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | ||
| Suppliers / Customized Equipment | 332BC3200X |
Profile Details
| NPI number | 1376663609 |
|---|---|
| LBN Legal business name | Avon Village Family Dentistry |
| DBA Doing business as | Avon Village Family Dentistry |
| Authorized official | Mentasti, Lauren M Doctor of Dental Medicine (DMD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 30th, 2007 |
| Last updated | Feb 5th, 2024 - about 10 months ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376663609 | NPPES |
| Connecticut | MEDICAID | 7587810001 |
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