1134148984 NPI number — DR. DAVID MARTIN PAGAR DAVID PAGAR, D.D.S.

Table of content: DR. DAVID MARTIN PAGAR DAVID PAGAR, D.D.S. (NPI 1134148984)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134148984 NPI number — DR. DAVID MARTIN PAGAR DAVID PAGAR, D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PAGAR
Provider First Name:
DAVID
Provider Middle Name:
MARTIN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DAVID PAGAR, D.D.S.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PAGAR
Provider Other First Name:
DAVID
Provider Other Middle Name:
MARTIN
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.D.S.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1134148984
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2900 MAIN STREET UNIT 2E
Provider Second Line Business Mailing Address:
UNIT 2E
Provider Business Mailing Address City Name:
STRATFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06614-4946
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-375-9063
Provider Business Mailing Address Fax Number:
203-377-6129

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2900 MAIN ST STE 2E
Provider Second Line Business Practice Location Address:
UNIT 2E
Provider Business Practice Location Address City Name:
STRATFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06614-4946
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-375-9063
Provider Business Practice Location Address Fax Number:
203-377-6129
Provider Enumeration Date:
07/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223S0112X , with the licence number:  004533 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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