Organization
SMILES ON THE GO RDH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROSA CLARK (OWNER)
(860) 380-0830
Entity
Organization
Contact information
Practice address
1 CHELSEA LN, EAST GRANBY, CT 06026-9634
(860) 380-0830
Mailing address
653 COLLEGE HWY, P.O. BOX 885, SOUTHWICK, MA 01077-0885
(860) 380-0830
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/10/2019
Last updated
02/10/2019
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