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General NPI Number Information
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NPI Number | 1932368644
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Entity Type | Organization
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Legal Business Name | DENTAL GROUP OF STAMFORD
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Dates
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Enumeration Date | 06/06/2008
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Last Update Date | 05/27/2009
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Provider Practice Location Address
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Address Line | 587 ELM ST
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City | STAMFORD
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State | CT
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Zip | 06902-5113
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Country | US
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Telephone | 203-359-6888
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Fax | 203-359-6625
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Provider Business Mailing Address
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Address Line | 587 ELM ST
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City | STAMFORD
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State | CT
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Zip | 06902-5113
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Country | US
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Telephone | 203-359-6888
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Fax | 203-359-6625
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Authorized Official
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Title or Position | OWNER
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Name | DR. MEHRAN ZAMANI
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Credential | DDS
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Telephone | 203-359-6888
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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 | 008810
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License Number State | CT
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