Provider Demographics
NPI:1902602394
Name:ELITE SMILES ARTISTRY, PLLC
Entity type:Organization
Organization Name:ELITE SMILES ARTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANATOLIY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MBA
Authorized Official - Phone:860-790-0260
Mailing Address - Street 1:283 CHESTNUT HILL RD
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06759-4104
Mailing Address - Country:US
Mailing Address - Phone:860-790-0260
Mailing Address - Fax:
Practice Address - Street 1:267 SPIELMAN HWY
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:CT
Practice Address - Zip Code:06013-1741
Practice Address - Country:US
Practice Address - Phone:860-470-5877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty