Provider Demographics
NPI:1174736920
Name:DANIEL R. SAUNDERS DMD PC
Entity type:Organization
Organization Name:DANIEL R. SAUNDERS DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:SAUNDERS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:860-647-9926
Mailing Address - Street 1:945 MAIN STREET SUITE 310
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040
Mailing Address - Country:US
Mailing Address - Phone:860-647-9926
Mailing Address - Fax:860-645-7723
Practice Address - Street 1:945 MAIN STREET SUITE 310
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040
Practice Address - Country:US
Practice Address - Phone:860-647-9926
Practice Address - Fax:860-645-7723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1223S0112X
CT77081223S0112X
CT89031223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008003579Medicaid
CT190000792Medicare PIN
CTT23420Medicare UPIN
CTU96303Medicare UPIN
CTU37718Medicare UPIN
CT190000475Medicare PIN