Provider Demographics
NPI:1326350596
Name:DEFINA, VINCENT BENJAMIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:BENJAMIN
Last Name:DEFINA
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 1:4 DEARFIELD DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-5351
Mailing Address - Country:US
Mailing Address - Phone:203-629-9009
Mailing Address - Fax:203-629-0039
Practice Address - Street 1:4 DEARFIELD DR
Practice Address - Street 2:SUITE 202
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-5351
Practice Address - Country:US
Practice Address - Phone:203-629-9009
Practice Address - Fax:203-629-0039
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-05
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT010457122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist