Provider Demographics
NPI:1861905036
Name:SMILES OF WINDSOR, LLC
Entity type:Organization
Organization Name:SMILES OF WINDSOR, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JATINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:860-503-9095
Mailing Address - Street 1:408 WINDSOR AVE
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-4467
Mailing Address - Country:US
Mailing Address - Phone:860-904-5015
Mailing Address - Fax:860-519-1242
Practice Address - Street 1:408 WINDSOR AVE
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-4467
Practice Address - Country:US
Practice Address - Phone:860-503-9095
Practice Address - Fax:860-644-1118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-09
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty