Provider Demographics
NPI:1124160833
Name:DAHL, NORMAN F III (DDS)
Entity type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:F
Last Name:DAHL
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:46 PARK PL
Mailing Address - Street 2:SUITE A
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-3774
Mailing Address - Country:US
Mailing Address - Phone:203-483-8806
Mailing Address - Fax:203-483-9922
Practice Address - Street 1:46 PARK PL
Practice Address - Street 2:SUITE A
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-3774
Practice Address - Country:US
Practice Address - Phone:203-483-8806
Practice Address - Fax:203-483-9922
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT008131122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist