Provider Demographics
NPI:1083862742
Name:DENTAL ART OF STAMFORD, L.L.C.
Entity Type:Organization
Organization Name:DENTAL ART OF STAMFORD, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:TEOFILO
Authorized Official - Middle Name:F
Authorized Official - Last Name:SERAFIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:203-359-3358
Mailing Address - Street 1:91 STRAWBERRY HILL AVE. SUITE 135
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902
Mailing Address - Country:US
Mailing Address - Phone:203-359-3358
Mailing Address - Fax:203-359-3341
Practice Address - Street 1:91 STRAWBERRY HILL AVE. SUITE 135
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902
Practice Address - Country:US
Practice Address - Phone:203-359-3358
Practice Address - Fax:203-359-3341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-05
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT009257122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty