| NPI | 1346600368 |
|---|---|
| Doing Business As | PORTLAND SMILE CARE |
| Entity Type | Organization |
| Authorized Contact | THOMAS P THALODY Owner 860-342-2176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CT 008931) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 004615) |
| Enumeration Date | 2016-03-03 |
| Last Update Date | 2016-03-03 |