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Organization

ROBERT E. SMITH DDS MPH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LYNANNE MADGIC (OFFICE MANAGER)
(203) 732-4747
Entity
Organization

Contact information

Practice address
115 NEW HAVEN AVE, DERBY, CT 06418-2154
(203) 732-4747
(203) 734-4101
Mailing address
115 NEW HAVEN AVE, DERBY, CT 06418-2154
(203) 732-4747
(203) 734-4101

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
010810
CT
124Q00000X
Dental Hygienist
007110
CT

Other

Enumeration date
08/30/2012
Last updated
08/30/2012
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