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General NPI Number Information
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NPI Number | 1497143267
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Entity Type | Individual
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Provider Name | DR. GEORGE LANDRESS
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Gender | Male
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Dates
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Enumeration Date | 01/02/2015
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Last Update Date | 01/02/2015
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Provider Practice Location Address
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Address Line | 93 WEST ST
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City | DANBURY
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State | CT
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Zip | 06810-6525
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Country | US
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Telephone | 203-743-7608
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Fax | 203-743-7610
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Provider Business Mailing Address
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Address Line | 93 WEST ST
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City | DANBURY
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State | CT
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Zip | 06810-6525
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Country | US
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Telephone | 203-743-7608
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Fax | 203-743-7610
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 5699
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License Number State | CT
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