Provider Demographics
NPI:1083237259
Name:DENTAL SMILES OF HARTFORD, PLLC
Entity Type:Organization
Organization Name:DENTAL SMILES OF HARTFORD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:AIGUIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-308-5361
Mailing Address - Street 1:171 MYSTIC ST APT 2
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-1145
Mailing Address - Country:US
Mailing Address - Phone:617-308-5361
Mailing Address - Fax:
Practice Address - Street 1:550 FARMINGTON AVE STE B
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-3041
Practice Address - Country:US
Practice Address - Phone:860-956-5555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-22
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty