Provider Demographics
NPI:1497160535
Name:GEORGE, DEAN DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:DAVID
Last Name:GEORGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 FARMINGTON AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1979
Mailing Address - Country:US
Mailing Address - Phone:860-676-7000
Mailing Address - Fax:860-676-7005
Practice Address - Street 1:399 FARMINGTON AVE STE 260
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1979
Practice Address - Country:US
Practice Address - Phone:860-676-7000
Practice Address - Fax:860-676-7005
Is Sole Proprietor?:No
Enumeration Date:2014-06-27
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1.065154207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology