MEDICARE: DR. ROBERT JOHN BADRIGIAN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	007551	CT

General Provider Information

NPI Number	:	1417950411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT JOHN BADRIGIAN DDS

Provider Business Mailing Address
First Line	:	5 S MAIN ST
Second Line	:	STE 515
City	:	BRANFORD
State	:	CT
Zip	:	06405-3846
Country	:	US
Telephone Number	:	203-488-7799
Fax Number	:	203-488-6899

Provider Business Practice Location Address
First Line	:	5 S MAIN ST
Second Line	:	STE 515
City	:	BRANFORD
State	:	CT
Zip	:	06405-3846
Country	:	US
Telephone Number	:	203-488-7799
Fax Number	:	203-488-6899

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	07/08/2007

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