Healthcare Provider Details

I. General information

NPI: 1356780688
Provider Name (Legal Business Name): DANIEL J ZAFFETTI D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2013
Last Update Date: 05/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CORPORATE DR
TRUMBULL CT
06611-1376
US

IV. Provider business mailing address

65 RAILROAD AVE APT 2H
MILFORD CT
06460-9210
US

V. Phone/Fax

Practice location:
  • Phone: 203-261-2511
  • Fax:
Mailing address:
  • Phone: 774-270-4128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN1857076
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: