Provider Demographics
NPI:1447428867
Name:SMILE ART LLC
Entity Type:Organization
Organization Name:SMILE ART LLC
Other - Org Name:SMILE ART ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:TEREDESAI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:203-210-7375
Mailing Address - Street 1:126 OLD RIDGEFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-3026
Mailing Address - Country:US
Mailing Address - Phone:203-210-7375
Mailing Address - Fax:203-210-7377
Practice Address - Street 1:126 OLD RIDGEFIELD RD
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-3026
Practice Address - Country:US
Practice Address - Phone:203-210-7375
Practice Address - Fax:203-210-7377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT89631223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty