Provider Demographics
NPI:1497160535
Name:GEORGE, DEAN DAVID (MD)
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:DAVID
Last Name:GEORGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 SEYMOUR ST STE 700
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-5533
Mailing Address - Country:US
Mailing Address - Phone:860-696-3350
Mailing Address - Fax:860-392-3647
Practice Address - Street 1:85 SEYMOUR ST STE 700
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5533
Practice Address - Country:US
Practice Address - Phone:860-696-3350
Practice Address - Fax:860-392-3647
Is Sole Proprietor?:No
Enumeration Date:2014-06-27
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1.065154207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology