Provider Demographics
NPI:1134774847
Name:DULCET DENTAL SMILES PC
Entity type:Organization
Organization Name:DULCET DENTAL SMILES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMINA
Authorized Official - Middle Name:YIXUAN
Authorized Official - Last Name:GONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:203-890-9300
Mailing Address - Street 1:579 NEWFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-3302
Mailing Address - Country:US
Mailing Address - Phone:203-890-9300
Mailing Address - Fax:
Practice Address - Street 1:579 NEWFIELD AVE
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-3302
Practice Address - Country:US
Practice Address - Phone:203-890-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty