Gerard E Bogucki DMS PC

Organization Active NPI General Practice Dentistry · Collinsville, CT

NPI 1063527786 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1063527786
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
5072 (CT)
Legal business name
GERARD E BOGUCKI DMS PC
Practice address
66 Maple Avenue
Collinsville, CT 06019
Phone
(860) 693-8314
Fax
(860) 693-4426
NPI assigned
Aug 20, 2006
Organization subpart
No

Authorized official

Name
Dr. Gerard Edward-Zackary Bogucki, DMD
Title
President
Phone
(860) 693-8314

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

66 Maple Ave
Collinsville, CT 06019
Phone (860) 693-8314

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193200000X MULTI-SPECIALTY GROUP
1223G0001X 5072 CT Yes

Addresses

Primary practice location

66 Maple Avenue
Collinsville, CT 06019

Mailing address

66 Maple Avenue
Collinsville, CT 06019
Phone (860) 693-8314

Other providers in Collinsville, CT

All providers in Collinsville, CT · General Practice Dentistry in Connecticut

Sources for this page

Verify at the official NPI Registry.