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Contact Information

JACK D DEGRADO, DDS
47 OAK ST
2ND FLOOR
STAMFORD, CT06905-5316
 Phone: 203-325-4700
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Prosthodontics

1223P0700X
Indicates primary specialty

NPI Profile & details for JACK D DEGRADO · (Male)

NPI # 1255468005
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 02/28/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • CT License # 008507
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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