| Divine Smiles PC | |
|
1574 Chapel St New Haven CT 06511-4205 | |
| (917) 428-4543 | |
| Not Available |
| Full Name | Divine Smiles PC |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1574 Chapel St, New Haven, Connecticut |
| Authorized Official Name and Position | Shande Adinyaguev (OWNER) |
| Authorized Official Contact | 9174284543 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Divine Smiles PC 1574 Chapel St New Haven CT 06511-4205 Ph: (203) 865-1480 | Divine Smiles PC 1574 Chapel St New Haven CT 06511-4205 Ph: (917) 428-4543 |
| NPI Number | 1184328551 |
|---|---|
| Provider Enumeration Date | 03/29/2023 |
| Last Update Date | 11/07/2023 |
| Certification Date | 11/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184328551 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
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