FAIRFIELD COUNTY IMPLANTS AND PERIODONTICS NPI 1518401702

NPI Information

FAIRFIELD COUNTY IMPLANTS AND PERIODONTICS is a periodontics dentist in Fairfield, CT. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. FAIRFIELD COUNTY IMPLANTS AND PERIODONTICS NPI is 1518401702. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1047 OLD POST RD
FAIRFIELD, CT
ZIP 06824-906
Phone: (203) 254-2006
Fax: (203) 254-9201

The provider's authorized official is Michael Kevin Sonick .
The authorized official title is Managing Partner and has the following contact phone number (203) 254-2006.

The CLIA number assigned to this NPI record is 07D2253745 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/7/2016 and was last updated on 12/7/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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