Provider Demographics
NPI:1568609386
Name:BRYNDA-HANSEN, DOROTA (DDS)
Entity Type:Individual
Prefix:DR
First Name:DOROTA
Middle Name:
Last Name:BRYNDA-HANSEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 BOSTON POST RD STE 5
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-3518
Mailing Address - Country:US
Mailing Address - Phone:203-795-0330
Mailing Address - Fax:203-795-6634
Practice Address - Street 1:472 BOSTON POST RD STE 5
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-3518
Practice Address - Country:US
Practice Address - Phone:203-795-0330
Practice Address - Fax:203-795-6634
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051676122300000X
CT0101631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist