Organization
DENTAL SMILES OF ORANGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRSHAD MOHAMMED DDS (OWNER)
(203) 553-9500
Entity
Organization
Contact information
Practice address
109 BOSTON POST RD, ORANGE, CT 06477-3235
(203) 553-9500
Mailing address
109 BOSTON POST RD, ORANGE, CT 06477-3235
(203) 553-9500
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376733139
—
CT
Enumeration date
09/13/2018
Last updated
10/09/2018
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