260 Main St Portland INC
NPI #1659946085 in Portland, Connecticut
Provider Information
- NPI Number
- 1659946085
- Entity Type
- Organization
- Organization Name
- 260 Main St Portland INC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- May 27, 2021
- Last Updated
- May 27, 2021
Practice Location
- Address
- 260 MAIN ST
- City
- Portland
- State
- Connecticut
- ZIP Code
- 06480-1859
- Phone
- (860) 342-2176
Authorized Official
- Name
- LONGQIAN WANG, DDS
- Title
- PRESIDENT
- Phone
- (929) 285-8883
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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