Organization
SMILES OF HARTFORD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELINA SANTA MARIA (BUSINESS FINANCE MANAGER)
(860) 997-0569
Entity
Organization
Contact information
Practice address
48 OCEAN AVE, NEW LONDON, CT 06320-3414
(860) 444-9345
(860) 443-0432
Mailing address
48 OCEAN AVE, NEW LONDON, CT 06320-3414
(860) 444-9345
(860) 443-0432
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073873
BUSINESS ID SECRETARY OF THE STATE OF CONNECTICUT
CT
Enumeration date
01/09/2014
Last updated
01/09/2014
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