Provider Demographics
NPI:1891257689
Name:PYRAMID FAMILY DENTAL CARE, LLC
Entity Type:Organization
Organization Name:PYRAMID FAMILY DENTAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:O'LOUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-288-8708
Mailing Address - Street 1:3308 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-1967
Mailing Address - Country:US
Mailing Address - Phone:203-288-8708
Mailing Address - Fax:475-238-8436
Practice Address - Street 1:3308 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-1967
Practice Address - Country:US
Practice Address - Phone:203-288-8708
Practice Address - Fax:475-238-8436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty