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Organization

FIRST IMPRESSIONS ORTHODONTICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMY PAUNDLAY (PRACTICE ADMINISTRATOR)
(203) 292-9594
Entity
Organization

Contact information

Practice address
1476 POST RD, FAIRFIELD, CT 06824-5937
(203) 292-9594
(203) 292-9596
Mailing address
1476 POST RD, FAIRFIELD, CT 06824-5937
(203) 292-9594
(203) 292-9596

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
009425
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1568692663
NPI
CT
01
1881084002
NPI
CT
Enumeration date
02/13/2015
Last updated
02/13/2015
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