Provider Demographics
NPI:1306378153
Name:DRS CHEN AND SEIGNEMARTIN LLC
Entity Type:Organization
Organization Name:DRS CHEN AND SEIGNEMARTIN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HISAKO
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIGNEMARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:203-248-5742
Mailing Address - Street 1:2080 WHITNEY AVE STE 270
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3603
Mailing Address - Country:US
Mailing Address - Phone:203-248-5742
Mailing Address - Fax:
Practice Address - Street 1:2080 WHITNEY AVE STE 270
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3603
Practice Address - Country:US
Practice Address - Phone:203-248-5742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-31
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT010478122300000X
CT117791223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty