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General NPI Number Information
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NPI Number | 1407182033
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Entity Type | Organization
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Legal Business Name | DR. DENTAL OF CONNECTICUT, PC
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Dates
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Enumeration Date | 11/02/2009
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 200 E MAIN ST
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City | STRATFORD
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State | CT
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Zip | 06614-5114
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Country | US
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Telephone | 203-378-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 200 E MAIN ST
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City | STRATFORD
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State | CT
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Zip | 06614-5114
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Country | US
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Telephone | 203-378-8500
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ALEX FAIGEL
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Credential |
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Telephone | 617-823-2111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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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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