Provider Demographics
NPI:1457939365
Name:SALON DIMENSIONS
Entity Type:Organization
Organization Name:SALON DIMENSIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COSMETOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:S
Authorized Official - Last Name:GORHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-529-1224
Mailing Address - Street 1:1A GOOD HILL RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:CT
Mailing Address - Zip Code:06883-2801
Mailing Address - Country:US
Mailing Address - Phone:203-529-1224
Mailing Address - Fax:
Practice Address - Street 1:114 W CEDAR ST
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06854-1963
Practice Address - Country:US
Practice Address - Phone:203-529-1224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment