Provider Demographics
NPI:1073646873
Name:FRYDMAN, PERRY (DDS)
Entity Type:Individual
Prefix:DR
First Name:PERRY
Middle Name:
Last Name:FRYDMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 KNAPP ST
Mailing Address - Street 2:STE 301
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06907-1741
Mailing Address - Country:US
Mailing Address - Phone:203-323-5905
Mailing Address - Fax:203-323-9285
Practice Address - Street 1:965 HOPE ST
Practice Address - Street 2:SUITE 102
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06907-2228
Practice Address - Country:US
Practice Address - Phone:203-323-5905
Practice Address - Fax:203-323-9285
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT67901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice