Provider Demographics
NPI:1124043328
Name:FINK, JUDD BENJAMIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JUDD
Middle Name:BENJAMIN
Last Name:FINK
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 1:56 RETREAT AVE
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-2526
Mailing Address - Country:US
Mailing Address - Phone:860-278-0777
Mailing Address - Fax:860-527-8806
Practice Address - Street 1:56 RETREAT AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-2526
Practice Address - Country:US
Practice Address - Phone:860-278-0777
Practice Address - Fax:860-527-8806
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT53961223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1351829OtherUNITED CONCORDIA
CT061024918003OtherCIGNA
CTP2786501OtherOXFORD
CT020005396CT04OtherANTHEM BS OF CT
CT1033603OtherFIRST HEALTH
CT078043OtherCONNECTICARE
CT020005396CT01OtherANTHEM BS OF CT
CT0708428OtherAETNA
CTT122193Medicare UPIN
CT1351829OtherUNITED CONCORDIA