Provider Demographics
NPI:1417073438
Name:VAUGHN FAMILY DENTISTRY PC
Entity Type:Organization
Organization Name:VAUGHN FAMILY DENTISTRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF PRACTICE
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:203-261-2511
Mailing Address - Street 1:965 WHITE PLAINS RD
Mailing Address - Street 2:BRINSMADE II
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-4566
Mailing Address - Country:US
Mailing Address - Phone:203-261-2511
Mailing Address - Fax:203-445-0023
Practice Address - Street 1:965 WHITE PLAINS RD
Practice Address - Street 2:BRINSMADE II
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4566
Practice Address - Country:US
Practice Address - Phone:203-261-2511
Practice Address - Fax:203-445-0023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty