Provider Demographics
NPI:1821195017
Name:SAFIAN, GARY D (DDS)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:D
Last Name:SAFIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 FOULK RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-3737
Mailing Address - Country:US
Mailing Address - Phone:302-652-8656
Mailing Address - Fax:302-652-1055
Practice Address - Street 1:707 FOULK RD
Practice Address - Street 2:SUITE 203
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3737
Practice Address - Country:US
Practice Address - Phone:302-652-8656
Practice Address - Fax:302-652-1055
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-00009231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice