Provider Demographics
NPI:1275848681
Name:MARIANA CONANT, DDS LLC
Entity Type:Organization
Organization Name:MARIANA CONANT, DDS LLC
Other - Org Name:FAMILY & COSMETIC DENTISTRY OF FAIRFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:CONANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-255-5999
Mailing Address - Street 1:1305 POST RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6016
Mailing Address - Country:US
Mailing Address - Phone:203-255-5999
Mailing Address - Fax:203-255-9972
Practice Address - Street 1:1305 POST RD
Practice Address - Street 2:SUITE 200
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6016
Practice Address - Country:US
Practice Address - Phone:203-255-5999
Practice Address - Fax:203-255-9972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0095441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty