| Orthodontic Boutique | |
|
126 Monroe Tpke Ste K Trumbull CT 06611-1300 | |
| (203) 590-3222 | |
| Not Available |
| Full Name | Orthodontic Boutique |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 126 Monroe Tpke Ste K, Trumbull, Connecticut |
| Authorized Official Name and Position | Casey Lonabocker (VICE PRESIDENT STRATEGY & OPERATION) |
| Authorized Official Contact | 5083457059 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Orthodontic Boutique 126 Monroe Tpke Ste K Trumbull CT 06611-1300 Ph: (203) 590-3222 | Orthodontic Boutique 126 Monroe Tpke Ste K Trumbull CT 06611-1300 Ph: (203) 590-3222 |
| NPI Number | 1124881537 |
|---|---|
| Provider Enumeration Date | 01/31/2024 |
| Last Update Date | 10/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124881537 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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