Healthy Smiles Dental Care, P.C.
Organization Active NPI General Practice Dentistry · Windsor Locks, CT
NPI 1104833862 · NPPES record last updated Nov 13, 2019
Key facts
- NPI
- 1104833862
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 009404 (CT)
- Legal business name
- HEALTHY SMILES DENTAL CARE, P.C.
- Practice address
- 20 Main St Ste 17
Windsor Locks, CT 06096-2345 - Phone
- (860) 623-2601
- Fax
- (860) 370-5467
- NPI assigned
- Aug 2, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Chung Kim, DMD
- Title
- President
- Phone
- (860) 623-2601
Practitioners 1
-
Chung K Kim, D.M.D.
National Provider Directory
Locations
255 Main St
Windsor Locks, CT 06096
20 Main St
Ste 17
Windsor Locks, CT 06096
Phone (860) 623-2601
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | 009404 | CT | Yes |
Addresses
Primary practice location
20 Main St Ste 17
Windsor Locks, CT 06096-2345
Mailing address
2O Main St
Ste 17
Windsor Locks, CT 06096-1916
Phone (860) 623-2601
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008003404 | Medicaid | CT |
Other providers in Windsor Locks, CT
- Lisa Jean Geckler
- Christine Goldfarb
- Cortora Sontique Green
- Happy Adams Transportation of Windsor Locks L L C
- Rebecca Michelle Harpin
- Holistic Healthcare
- House of Eve
- Jennell Ifill
- Jaquar Limo LLC
- Sheldon Kafer
All providers in Windsor Locks, CT · General Practice Dentistry in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.