Organization
DYNOBITE SMILES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RAVEN VANESSA HENDERSON DDS (OWNER/DENTIST)
(203) 577-3500
Entity
Organization
Contact information
Practice address
765 STRAITS TPKE, MIDDLEBURY, CT 06762-2853
(203) 577-3500
(203) 577-3600
Mailing address
765 STRAITS TPKE, MIDDLEBURY, CT 06762-2853
(203) 577-3500
(203) 577-3600
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
009463
CT
Other
Enumeration date
05/08/2013
Last updated
05/08/2013
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