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General NPI Number Information
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NPI Number | 1326646399
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Entity Type | Organization
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Legal Business Name | RESTORATION SMILES, P.C.
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Dates
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Enumeration Date | 10/13/2020
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Last Update Date | 10/13/2020
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Provider Practice Location Address
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Address Line | 2 COOLIDGE ST STE 202
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City | HUDSON
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State | MA
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Zip | 01749-1459
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Country | US
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Telephone | 845-863-9987
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Fax |
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Provider Business Mailing Address
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Address Line | 22 AUTUMN LN
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City | BOLTON
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State | MA
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Zip | 01740-1056
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Country | US
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Telephone | 845-863-9987
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Fax |
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Authorized Official
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Title or Position | OWNER, PEDIATRIC DENTIST
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Name | DR. VERONICA MITKO
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Credential | DMD
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Telephone | 845-863-9987
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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