Blue Back Dental LLC
Dentist, General Practice in West Hartford, Connecticut
1174814495- Practice location
- 65 Memorial RD Ste 400, West Hartford, CT 06107-4219
- Phone
- 860-233-9300
- Fax
- 860-233-9304
- Last updated
- April 20, 2011
Blue Back Dental LLC is a healthcare organization based in West Hartford, CT. Blue Back Dental LLC practices in West Hartford, CT. The NPI Number for Blue Back Dental LLC is 1174814495 and holds a License No. 8915 (CT). The current practice location address for Blue Back Dental LLC is 65 Memorial RD Ste 400, West Hartford, CT 06107-4219 and can be reached out via phone at 860-233-9300 and via fax at 860-233-9304.
Provider Profile Details
- NPI Number
- 1174814495
- Provider Name
- Blue Back Dental LLC
- Provider Entity Type
- Organization
- Address
- 65 Memorial RD Ste 400, West Hartford, CT 06107-4219
- Phone Number
- 860-233-9300
- Fax Number
- 860-233-9304
- Primary Taxonomy
- Dentist, General Practice · 1223G0001X
- Organization Subpart
- No
- Authorized Official
- Kirsten E Capozzi · Practice Manager · 860-233-9300
- Provider Enumeration Date
- April 20, 2011
- Last Update Date
- April 20, 2011
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 65 Memorial RD Ste 400
West Hartford, CT 06107-4219 - City
- West Hartford
- State
- Connecticut
- Zip
- 06107-4219
- Phone Number
- 860-233-9300
- Fax Number
- 860-233-9304
Provider Business Mailing Address Details
- Address
- 65 Memorial RD Ste 400
West Hartford, CT 06107-4219 - City
- West Hartford
- State
- CT
- Zip
- 06107-4219
- Phone Number
- 860-233-9300
- Fax Number
- 860-233-9304
License Information
- License Number (1)
- 8915
- License State (1)
- CT
- Taxonomy (1)
- Dentist, General Practice · 1223G0001X
- License Number (2)
- 5407
- License State (2)
- CT
- Taxonomy (2)
- Dentist, Periodontics · 1223P0300X
- License Number (3)
- 5904
- 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. | |||
Other Dentist, General Practice providers near West Hartford, CT
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- Dr. Alan W James, DMDDentist, General Practice · NPI 1912919754
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Frequently Asked Questions
What is the NPI number of Blue Back Dental LLC?
The NPI number of Blue Back Dental LLC is 1174814495. It was assigned on April 20, 2011 and is currently active in the NPPES registry.
What is the specialty of Blue Back Dental LLC?
Blue Back Dental LLC is registered under the primary taxonomy Dentist, General Practice (code 1223G0001X), licensed in CT under license number 8915.
Where does Blue Back Dental LLC practice?
The practice location is 65 Memorial RD Ste 400, West Hartford, CT 06107-4219. The office can be reached at 860-233-9300 (phone) or 860-233-9304 (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 1174814495 directly on the NPPES registry website.