Organization
ISMILE ORTHODONTICS OF WATERBURY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EFSTATHIOS GIANNOUTSOS DDS (OWNER)
(917) 518-9128
Entity
Organization
Contact information
Practice address
464 REIDVILLE DRIVE, SUITE A4, WATERBURY, CT 06705-2650
(203) 601-6423
(203) 575-8399
Mailing address
464 REIDVILLE DRIVE, SUITE A4, WATERBURY, CT 06705-2650
(203) 601-6423
(203) 575-8399
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
08/02/2023
Last updated
08/02/2023
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