Organization
PRISTINE SMILE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON LEE HERNANDEZ DMD (DENTIST OWNER)
(860) 990-1792
Entity
Organization
Contact information
Practice address
599 MAIN ST STE 4, MANCHESTER, CT 06040-5156
(860) 647-1565
(860) 643-2796
Mailing address
599 MAIN ST STE 4, MANCHESTER, CT 06040-5156
(860) 647-1565
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/20/2022
Last updated
02/20/2022
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