Provider Demographics
NPI:1528841996
Name:CLOVE FAMILY DENTISTRY, INC
Entity type:Organization
Organization Name:CLOVE FAMILY DENTISTRY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SONAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HASIJA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:585-545-0090
Mailing Address - Street 1:201 TRAILS END RD APT 201
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06042-7108
Mailing Address - Country:US
Mailing Address - Phone:585-545-0090
Mailing Address - Fax:
Practice Address - Street 1:33 LEXINGTON ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-1446
Practice Address - Country:US
Practice Address - Phone:585-545-0090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty