Individual
DR. KHANITHA TANGNAVARAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1 STRAWBERRY HILL COURT, STAMFORD, CT 06902
(203) 324-2800
Mailing address
1 STRAWBERRY HILL COURT, STAMFORD, CT 06902
(203) 324-2800
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
8081
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8597916000
TAX REGISTRATION
CT
Enumeration date
11/09/2006
Last updated
07/08/2007
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