Provider Demographics
NPI:1881805158
Name:DANZIGER, STEWART S (DMD)
Entity type:Individual
Prefix:
First Name:STEWART
Middle Name:S
Last Name:DANZIGER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 EAST HIGH ST
Mailing Address - Street 2:
Mailing Address - City:EAST HAMPTON
Mailing Address - State:CT
Mailing Address - Zip Code:06424
Mailing Address - Country:US
Mailing Address - Phone:860-267-2549
Mailing Address - Fax:860-365-0690
Practice Address - Street 1:190 EAST HIGH ST
Practice Address - Street 2:
Practice Address - City:EAST HAMPTON
Practice Address - State:CT
Practice Address - Zip Code:06424
Practice Address - Country:US
Practice Address - Phone:860-267-2549
Practice Address - Fax:860-365-0690
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004765122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist