Branford Dental Group, LLC
Organization Active NPI General Practice Dentistry · Stratford, CT
NPI 1396103255 · NPPES record last updated Feb 8, 2016
Key facts
- NPI
- 1396103255
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 010878 (CT)
- Legal business name
- BRANFORD DENTAL GROUP, LLC
- Practice address
- 1100 Barnum Ave
Stratford, CT 06614 - Phone
- (203) 864-3430
- Fax
- (203) 378-2759
- NPI assigned
- Feb 8, 2016
- Organization subpart
- No
Authorized official
- Name
- Dr. Dharam P Tayal, DDS
- Title
- Owner
- Phone
- (203) 864-3430
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Branford Dental Group LLC
Locations
1060 W Main St
Branford, CT 06405
Phone (203) 864-3750
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | 010878 | CT | Yes |
Addresses
Primary practice location
1100 Barnum Ave
Stratford, CT 06614
Mailing address
1060 West Main Street
Brandford, CT 06405
Phone (203) 864-3430
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.