NPI 1396113064

Diamond Dental LLC

Organisation Preferred Provider Organization Newtown, CT

Practice location

Address: 274 S Main St Unit C9, Newtown, CT 06470-6705
Phone: (203) 403-2446

Authorised official

Name: Ratna Vedullapalli
Title: Member, Owner
Phone: (908) 930-1938

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 010135 (CT)

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Registry record

NPI: 1396113064
Entity type: Organization
NPI issued: 10 Sep 2015
Record last updated: 10 Sep 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.