| NPI | 1255817813 |
|---|---|
| Doing Business As | SOUTHPORT SMILES |
| Entity Type | Organization |
| Authorized Contact | DENNIS RAGOZA Dentist 203-767-7269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CT 11890) |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2018-07-17 |