| Revitalizing Smiles, Llc | |
|
2226 Black Rock Tpke Fairfield CT 06825-3240 | |
| (203) 332-9049 | |
| (203) 366-6287 |
| Full Name | Revitalizing Smiles, Llc |
|---|---|
| Speciality | Dentist - Prosthodontics |
| Location | 2226 Black Rock Tpke, Fairfield, Connecticut |
| Authorized Official Name and Position | Judith Horblitt (MANAGER) |
| Authorized Official Contact | 2033329049 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revitalizing Smiles, Llc 2226 Black Rock Tpke Fairfield CT 06825-3240 Ph: (203) 332-9049 | Revitalizing Smiles, Llc 2226 Black Rock Tpke Fairfield CT 06825-3240 Ph: (203) 332-9049 |
| NPI Number | 1588058077 |
|---|---|
| Provider Enumeration Date | 03/24/2015 |
| Last Update Date | 03/24/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588058077 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0700X | Dentist - Prosthodontics | 11048 (Connecticut) | Primary |
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