MEDICARE: FAMILY DENTAL GROUP MILFORD LLC

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	7406	CT
2	1223G0001X	General Practice Dentistry	9408	CT
3	1223P0300X	Periodontics	8178	CT
4	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	2582	CT
5	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	6481	CT

General Provider Information

NPI Number	:	1669683553
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY DENTAL GROUP MILFORD LLC

Provider Business Mailing Address
First Line	:	59 TURNPIKE SQ
Second Line	:
City	:	MILFORD
State	:	CT
Zip	:	06460-2758
Country	:	US
Telephone Number	:	203-876-6161
Fax Number	:

Provider Business Practice Location Address
First Line	:	59 TURNPIKE SQ
Second Line	:
City	:	MILFORD
State	:	CT
Zip	:	06460-2758
Country	:	US
Telephone Number	:	203-876-6161
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KENNETH M EPSTEIN
Credential	:	DDS
Telephone Number	:	203-876-6161

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	09/11/2025

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