Organization
CONNECTICUT SMILES LLC
Active
Other names
Kristal Smiles
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS BRAUN (MANAGER)
(203) 754-7100
Entity
Organization
Contact information
Practice address
109 WATERTOWN AVE STE 1, WATERBURY, CT 06708-2623
(203) 754-7100
Mailing address
427 STILLSON RD STE 12, FAIRFIELD, CT 06824-3158
(203) 374-0512
(203) 372-0280
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
005825
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P002058253
—
CT
Enumeration date
04/17/2015
Last updated
04/17/2015
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