Provider Demographics
NPI:1558670471
Name:NORWICH SMILES FAMILY DENTISTRY
Entity type:Organization
Organization Name:NORWICH SMILES FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:T
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:860-889-5166
Mailing Address - Street 1:514 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-5321
Mailing Address - Country:US
Mailing Address - Phone:860-889-5166
Mailing Address - Fax:860-887-8254
Practice Address - Street 1:514 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-5321
Practice Address - Country:US
Practice Address - Phone:860-889-5166
Practice Address - Fax:860-887-8254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty