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

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Branford Dental Group LLC (2 organizations share this tax ID)

Locations

1060 W Main St
Branford, CT 06405
Phone (203) 864-3750

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
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

Other providers in Stratford, CT

All providers in Stratford, CT · General Practice Dentistry in Connecticut

Sources for this page

Verify at the official NPI Registry.