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General NPI Number Information
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NPI Number | 1417073438
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Entity Type | Organization
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Legal Business Name | VAUGHN FAMILY DENTISTRY PC
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 965 WHITE PLAINS RD BRINSMADE II
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City | TRUMBULL
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State | CT
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Zip | 06611-4566
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Country | US
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Telephone | 203-261-2511
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Fax | 203-445-0023
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Provider Business Mailing Address
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Address Line | 965 WHITE PLAINS RD BRINSMADE II
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City | TRUMBULL
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State | CT
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Zip | 06611-4566
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Country | US
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Telephone | 203-261-2511
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Fax | 203-445-0023
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Authorized Official
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Title or Position | OWNER OF PRACTICE
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Name | BRIAN SCOTT VAUGHN
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Credential | DMD
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Telephone | 203-261-2511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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