Provider Demographics
NPI:1063869162
Name:BRADFORD J. PINKOS, DMD, LLC
Entity type:Organization
Organization Name:BRADFORD J. PINKOS, DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADFORD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:PINKOS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:203-733-5258
Mailing Address - Street 1:29 PLANZ LN
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:CT
Mailing Address - Zip Code:06752-1235
Mailing Address - Country:US
Mailing Address - Phone:860-799-6996
Mailing Address - Fax:
Practice Address - Street 1:29 PLANZ LN
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:CT
Practice Address - Zip Code:06752-1235
Practice Address - Country:US
Practice Address - Phone:860-799-6996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-18
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0115461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty