Provider Demographics
NPI:1437609211
Name:FAMILY DENTAL CARE OF STAMFORD, LLC
Entity Type:Organization
Organization Name:FAMILY DENTAL CARE OF STAMFORD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FROMZEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:203-569-0880
Mailing Address - Street 1:50 GLENBROOK RD
Mailing Address - Street 2:STE. 1-D
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-2969
Mailing Address - Country:US
Mailing Address - Phone:203-569-0880
Mailing Address - Fax:203-569-0881
Practice Address - Street 1:50 GLENBROOK RD
Practice Address - Street 2:STE. 1-D
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-2969
Practice Address - Country:US
Practice Address - Phone:203-569-0880
Practice Address - Fax:203-569-0881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0096101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty