Provider Demographics
NPI:1235289190
Name:TRAILOR, CHRISTOPHER TODD (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:TODD
Last Name:TRAILOR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 ACORN RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06073-3500
Mailing Address - Country:US
Mailing Address - Phone:860-633-3124
Mailing Address - Fax:
Practice Address - Street 1:130 NEW LONDON TPKE
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2624
Practice Address - Country:US
Practice Address - Phone:860-889-3889
Practice Address - Fax:860-889-3539
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0076731223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics