Canton Valley Dental LLC
Dentist, General Practice in Canton, Connecticut
1154560118- Practice location
- 191 Albany Tpke, Canton, CT 06019-2554
- Phone
- 860-693-0887
- Fax
- 860-693-1079
- Last updated
- September 9, 2021
Canton Valley Dental LLC is a healthcare organization based in Canton, CT. Canton Valley Dental LLC practices in Canton, CT. The NPI Number for Canton Valley Dental LLC is 1154560118 and holds a License No. 8462 (CT). The current practice location address for Canton Valley Dental LLC is 191 Albany Tpke, Canton, CT 06019-2554 and can be reached out via phone at 860-693-0887 and via fax at 860-693-1079.
Provider Profile Details
- NPI Number
- 1154560118
- Provider Name
- Canton Valley Dental LLC
- Provider Entity Type
- Organization
- Address
- 191 Albany Tpke, Canton, CT 06019-2554
- Phone Number
- 860-693-0887
- Fax Number
- 860-693-1079
- Primary Taxonomy
- Dentist, General Practice · 1223G0001X
- Organization Subpart
- No
- Authorized Official
- Dr. Matthew Keefe, DMD · Dentist/Partner · 860-693-0887
- Provider Enumeration Date
- February 16, 2009
- Last Update Date
- September 9, 2021
- Certification Date
- September 9, 2021
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 191 Albany Tpke
Canton, CT 06019-2554 - City
- Canton
- State
- Connecticut
- Zip
- 06019-2554
- Phone Number
- 860-693-0887
- Fax Number
- 860-693-1079
Provider Business Mailing Address Details
- Address
- Po Box 456
Canton, CT 06019-0456 - City
- Canton
- State
- CT
- Zip
- 06019-0456
- Phone Number
- 860-693-0887
- Fax Number
- 860-693-1079
License Information
- License Number (1)
- 8462
- License State (1)
- CT
- Taxonomy (1)
- Dentist, General Practice · 1223G0001X
- License Number (2)
- 5137
- License State (2)
- CT
- Taxonomy (2)
- Dentist, General Practice · 1223G0001X
- License Number (3)
- 9636
- License State (3)
- CT
- Taxonomy (3)
- Dentist, General Practice · 1223G0001X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Canton Valley Dental LLC?
The NPI number of Canton Valley Dental LLC is 1154560118. It was assigned on February 16, 2009 and is currently active in the NPPES registry.
What is the specialty of Canton Valley Dental LLC?
Canton Valley Dental LLC is registered under the primary taxonomy Dentist, General Practice (code 1223G0001X), licensed in CT under license number 8462.
Where does Canton Valley Dental LLC practice?
The practice location is 191 Albany Tpke, Canton, CT 06019-2554. The office can be reached at 860-693-0887 (phone) or 860-693-1079 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1154560118 directly on the NPPES registry website.