Organization
HS SMILES,LLC
Active
Other names
Primedentalcare
Organization subpart
No
Provider details
NPI number
Authorized official
THULASISWARNA MUPPURU DDS (MEMBER MANAGER)
(203) 664-1994
Entity
Organization
Contact information
Practice address
2 LONG RIDGE RD, WEST REDDING, CT 06896-1111
(203) 664-1994
Mailing address
2 LONG RIDGE RD, WEST REDDING, CT 06896-1111
(203) 664-1994
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10318
CT
1223G0001X
General Practice Dentistry
—
—
Other
Enumeration date
09/01/2017
Last updated
09/01/2017
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