TERCEL DENTAL PLLC (NPI# 1538674262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538674262 |
| Entity Type | Organization |
| Organization Name | TERCEL DENTAL PLLC |
| Practice Address |
643 Gold Star Hwy. Groton CT 06340 |
| Practice Telephone | 8604458569 |
| Practice Fax Number | 8604468434 |
| Mailing Telephone | 8604458569 |
| Mailing Fax Number | 8604468434 |
| Enumeration Date | 2017-12-04 |
| Last Update Date | 2017-12-04 |
| Authorized Official Name | LESLIE L. MATZDORFF (OFFICE MANAGER) |
| Authorized Official Telephone | 8604458569 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
643 GOLD STAR HWY. |
| City | GROTON |
| State | CT |
| Zip Code | 06340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912558610 | Bruce Lancel Bernardo Lara | Military Health Care Provider | Fpo, Ae, 09587-2417, Groton, AE 06340 | 2019-09-24 |
| 1295393692 | Ermelinda Elaine Alviso | Military Health Care Provider | Trout Ave, Groton, CT 06340 | 2019-05-31 |
| 1679034011 | Derek James Hale | Military Health Care Provider | Fc 83 Numi, Trout Ave, Groton, CT 06340 | 2019-03-28 |
| 1063973790 | Cody Eugene Shaw | Military Health Care Provider | Numi, Trout Ave Building 83, Groton, CT 06340 | 2019-03-26 |
| 1265906911 | Homelife Companions and Homemakers, LLC | Adult Companion | 1 Fort Hill Road, Suite 3, Groton, CT 06340 | 2019-01-16 |
| 1144735457 | Kristina Marie Carta | Behavior Technician | 220 Rt 12, Suite 205, Groton, CT 06340 | 2017-12-08 |
| 1306361662 | Stonington Behavioral Health Inc | Psychologist | 618 Poquonnock Rd, Groton, CT 06340 | 2017-08-08 |
| 1104347806 | Renae Reynolds | Optometrist | 489 Gold Star Hwy Ste 100, Groton, CT 06340 | 2017-07-03 |
| 1053831552 | Susan A Bradbury | Physical Therapist | 455 Eastern Point Rd, Groton, CT 06340 | 2017-06-26 |
| 1770932220 | Matthew Kermit Lee | Military Health Care Provider | 465 Trout Ave, Numi, Groton, CT 06340 | 2016-06-06 |
| Find all providers in zip 06340 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306452479 | Robert James Wollschlager | Dentist | 495 Route 184 Ste 312, Groton, CT 06340-6230 | 2020-09-23 |
| 1457420770 | Connecticut Dental Groups | Dentist | 1100 Poquonnock Rd, Groton, CT 06340 | 2006-11-08 |
| 1740379635 | John Joseph Widlak Jr. | Dentist | 163 Ledgewood Rd, Apt 412, Groton, CT 06340-6611 | 2006-10-11 |
| 1063512853 | J Michael Tiberii | Dentist | 643 Route 184, Groton, CT 06340 | 2006-09-22 |
| 1497866875 | Jennifer Lee Mackey | Dentist | 423 Long Hill Rd, Groton, CT 06340-3812 | 2006-08-31 |
| 1043207004 | Matthew Braden Burns Miller | Dentist | 1 Wahoo Ave, Groton, CT 06349 | 2005-10-04 |
| 1336141068 | John M Johnson | Dentist | 643 Gold Star Hwy, Groton, CT 06340-6267 | 2005-08-12 |
| 1063027407 | Jimmy Nazih Suliman | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2020-09-12 |
| 1790395242 | Duc-nhan Nguyen Pham | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2020-08-08 |
| 1477103059 | Jordan Taylor Rucinski | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2019-09-16 |
| Find all providers in GROTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.