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General NPI Number Information
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NPI Number | 1154233625
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Entity Type | Organization
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Legal Business Name | MONAMI SMILES PLLC
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Dates
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Enumeration Date | 09/21/2026
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Last Update Date | 09/21/2026
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Provider Practice Location Address
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Address Line | 1192 MAIN ST STE 1
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City | WATERTOWN
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State | CT
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Zip | 06795-3131
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Country | US
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Telephone | 860-274-9211
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Fax | 860-274-3183
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Provider Business Mailing Address
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Address Line | 47 MOUNTAIN VIEW RD
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City | GLASTONBURY
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State | CT
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Zip | 06033-3525
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAEWOO LEE
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Credential | DMD
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Telephone | 617-909-8945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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