Provider Demographics
NPI:1073827523
Name:DENTAL GROUP OF DANBURY,PC
Entity Type:Organization
Organization Name:DENTAL GROUP OF DANBURY,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NEGAR
Authorized Official - Middle Name:
Authorized Official - Last Name:LOTFI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-728-6962
Mailing Address - Street 1:2 GLEN HILL RD
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-4906
Mailing Address - Country:US
Mailing Address - Phone:516-728-6962
Mailing Address - Fax:914-764-3434
Practice Address - Street 1:2 GLEN HILL RD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-4906
Practice Address - Country:US
Practice Address - Phone:516-728-6962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-27
Last Update Date:2010-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0088101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty