Provider Demographics
NPI:1215166301
Name:UNITED DENTAL RESOURCES LLC
Entity type:Organization
Organization Name:UNITED DENTAL RESOURCES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:NATELLI
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:203-758-0503
Mailing Address - Street 1:60 WATERBURY RD
Mailing Address - Street 2:PO BOX 7037
Mailing Address - City:PROSPECT
Mailing Address - State:CT
Mailing Address - Zip Code:06712-1250
Mailing Address - Country:US
Mailing Address - Phone:203-758-0503
Mailing Address - Fax:203-758-0127
Practice Address - Street 1:60 WATERBURY RD
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:CT
Practice Address - Zip Code:06712-1250
Practice Address - Country:US
Practice Address - Phone:203-758-0503
Practice Address - Fax:203-758-0127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007729122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty