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Organization
ORAL CARE DENTAL GROUP II, LLC
Active
Organization
ORAL CARE DENTAL GROUP II, LLC
Active
Other names
Smiles of Hartford
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGELINA SANTA MARIA (BUSINESS/FINANCE MANAGER)
(860) 444-9345
Entity
Organization
Contact information
Practice address
330 MAIN ST, HARTFORD, CT 06106-1860
(860) 444-9345
Mailing address
330 MAIN ST, HARTFORD, CT 06106-1860
(860) 444-9345
(860) 443-0432
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8727
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002087270
—
CT
01
—
8727
CONNECTICUT STATE DENTAL LICENSE
CT
Enumeration date
07/07/2011
Last updated
08/23/2011
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