Provider Demographics
NPI:1013290147
Name:COMFORT DENTAL LLC
Entity Type:Organization
Organization Name:COMFORT DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOAY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMAD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:973-897-3191
Mailing Address - Street 1:142 PLEASANT VALLEY ST
Mailing Address - Street 2:APT.210102
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-7218
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:31 WILLIAM SHORTY CAMPBELL ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-3401
Practice Address - Country:US
Practice Address - Phone:973-897-3191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT010612122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty