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Organization

DYNOBITE SMILES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RAVEN ROBERTS HENDERSON DDS (PRESIDENT)
(203) 577-3500
Entity
Organization

Contact information

Practice address
765 STRAITS TPKE, DYNOBITE SMILES, MIDDLEBURY, CT 06762-2853
(203) 577-3500
(203) 577-3600
Mailing address
765 STRAITS TPKE, DYNOBITE SMILES, MIDDLEBURY, CT 06762-2853
(203) 577-3500
(203) 577-3600

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
9463
CT

Other

Enumeration date
04/07/2010
Last updated
04/07/2010
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