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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