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General NPI Number Information
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NPI Number | 1750957775
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Entity Type | Organization
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Legal Business Name | CEDAR DENTAL TEAM PLLC
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Dates
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Enumeration Date | 06/01/2021
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Last Update Date | 06/01/2021
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Provider Practice Location Address
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Address Line | 120 CLAPBOARD RIDGE RD STE 101
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City | DANBURY
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State | CT
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Zip | 06811-3625
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Country | US
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Telephone | 203-744-5941
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Fax |
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Provider Business Mailing Address
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Address Line | 8 CAWDOR BURN RD
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City | BROOKFIELD
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State | CT
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Zip | 06804-3601
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Country | US
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Telephone | 203-241-2776
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DANY TAWK
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Credential | DMD
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Telephone | 203-241-2776
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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 |
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License Number State |
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