Lansford, Jeremy Shane

Lansford, Jeremy Shane is an individual health care provider with primary practice located at 180 Marbern Dr , Suffield CT 06078-1535. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Lansford, Jeremy Shane can be contacted via phone (210) 455-5571.

Contact Information

Primary practice address
180 Marbern Dr Suffield CT 06078-1535
Phone: (210) 455-5571
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 009319 Connecticut
Dental Providers / Dentist 122300000X 8803 Tennessee
Dental Providers / Dentist 122300000X 0401412410 Virginia

Profile Details

NPI number 1174577811
LBN Legal business name Lansford, Jeremy Shane
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 19th, 2006
Last updated Mar 31st, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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