Organization
REVITALIZING SMILES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH HORBLITT (MANAGER)
(203) 332-9049
Entity
Organization
Contact information
Practice address
2226 BLACK ROCK TPKE, FAIRFIELD, CT 06825-3240
(203) 332-9049
(203) 366-6287
Mailing address
2226 BLACK ROCK TPKE, FAIRFIELD, CT 06825-3240
(203) 332-9049
(203) 366-6287
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
11048
CT
Other
Enumeration date
03/24/2015
Last updated
03/24/2015
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