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General NPI Number Information
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NPI Number | 1467389270
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Entity Type | Organization
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Legal Business Name | DIVINE SMILES NORTH HAVEN PC
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Dates
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Enumeration Date | 05/06/2026
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Last Update Date | 05/06/2026
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Provider Practice Location Address
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Address Line | 6 GEORGE ST
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City | NORTH HAVEN
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State | CT
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Zip | 06473-1822
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Country | US
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Telephone | 203-865-1480
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Fax |
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Provider Business Mailing Address
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Address Line | 1574 CHAPEL ST
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City | NEW HAVEN
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State | CT
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Zip | 06511-4205
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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 | DR. SHANDE ADINYAGUEV
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Credential | DDS
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Telephone | 917-428-4543
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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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