Provider Demographics
NPI:1811166101
Name:GRIFFIN, DEBORAH S (DMD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:S
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 MERLINE RD
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-4040
Mailing Address - Country:US
Mailing Address - Phone:860-875-1886
Mailing Address - Fax:
Practice Address - Street 1:351 MERLINE RD
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-4040
Practice Address - Country:US
Practice Address - Phone:860-875-1886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0098681223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics