Organization
SPARKLING SMILES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NISHIT MODI (OWNER)
(860) 329-6539
Entity
Organization
Contact information
Practice address
148 TALCOTTVILLE RD, VERNON, CT 06066-4705
(860) 926-4789
Mailing address
685 QUEEN ST UNIT 3, SOUTHINGTON, CT 06489-1547
(860) 863-5831
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/29/2019
Last updated
10/29/2019
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