Organization
ISMILE FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUBINA ALI D.M.D (OWNER)
(617) 335-8334
Entity
Organization
Contact information
Practice address
765 MAIN ST, EAST HARTFORD, CT 06108-3123
(617) 335-8334
(860) 679-9389
Mailing address
1 WENTWORTH PLACE, AVON, CT 06001
(617) 335-8334
(860) 679-9389
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
009436
CT
122300000X
Dentist
009576
CT
1223G0001X
General Practice Dentistry
Primary
9436
CT
1223P0300X
Periodontics
010145
CT
Other
Enumeration date
09/24/2010
Last updated
05/03/2013
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