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Organization
DIVINE DENTISTRY PC
Active
Organization
DIVINE DENTISTRY PC
Active
Other names
Divine Dentistry at Fairfield
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ALEXIA KENNEDY (RECEPTIONIST)
(203) 372-9848
Entity
Organization
Contact information
Practice address
2452 BLACK ROCK TPKE STE 12, FAIRFIELD, CT 06825-2417
(203) 372-9848
Mailing address
2452 BLACK ROCK TPKE STE 12, FAIRFIELD, CT 06825-2417
(203) 372-9848
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/23/2023
Last updated
02/23/2023
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