Organization
DIVINE DENTISTRY PC
Active
Other names
Divine Dentistry at Fairfield
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ALEXIA KENNEDY (RECEPTIONIST)
(203) 372-9848
Entity
Organization
Contact information
Practice address
2452 BLACK ROCK TPKE STE 12, FAIRFIELD, CT 06825-2417
(203) 372-9848
Mailing address
2452 BLACK ROCK TPKE STE 12, FAIRFIELD, CT 06825-2417
(203) 372-9848
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/23/2023
Last updated
02/23/2023
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