Bolton Lake Dental LLC
NPI #1194357418 in Bolton, Connecticut
Provider Information
- NPI Number
- 1194357418
- Entity Type
- Organization
- Organization Name
- Bolton Lake Dental LLC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Feb 5, 2020
- Last Updated
- Feb 5, 2020
Practice Location
- Address
- 1120 BOSTON TPKE
- City
- Bolton
- State
- Connecticut
- ZIP Code
- 06043-7439
- Phone
- (860) 646-3003
Authorized Official
- Name
- DR. CRISTINA ILIES, DDS
- Title
- OWNER
- Phone
- (860) 646-3003
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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