Provider Demographics
NPI:1578709671
Name:FAIRFIELD-MONROE ORTHODONTICS, LLC
Entity Type:Organization
Organization Name:FAIRFIELD-MONROE ORTHODONTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FIGEN
Authorized Official - Middle Name:AYSE
Authorized Official - Last Name:BAYDUR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:203-333-0050
Mailing Address - Street 1:1817 BLACK ROCK TPKE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-3546
Mailing Address - Country:US
Mailing Address - Phone:203-333-0050
Mailing Address - Fax:203-333-6333
Practice Address - Street 1:1817 BLACK ROCK TPKE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-3546
Practice Address - Country:US
Practice Address - Phone:203-333-0050
Practice Address - Fax:203-333-6333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-21
Last Update Date:2008-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0095631223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty