Doctor Name: | DR. MARYAM AZADPUR |
NPI Number: | 1144238395 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DMD |
License Number: | 007907 |
Business Practice Address: | 381 Hopmeadow St Suite 202 Simsbury, CT - 060899692 |
Business Phone Number: | 8606587548 |
Business Fax Number: | 8606587516 |
Mailing Address: | 381 Hopmeadow St, Suite 202 SIMSBURY |
State: | CT |
Postal Code: | 060899692 |
Phone Number: | 8606587548 |
Fax Number: | 8606587516 |
NPI Enumeration Date: | 08/04/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 007907 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |