Gretchen R. Cianciola, BSDH

Individual provider Active NPI Dental Hygienist · Middlebury, CT

NPI 1437423985 · NPPES record last updated Mar 1, 2012

Key facts

NPI
1437423985
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
004868 (CT)
Practice address
12 Nantucket Way
Middlebury, CT 06762
Phone
(203) 305-3795
NPI assigned
Mar 1, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
004868CTMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 004868 CT Yes

Addresses

Primary practice location

12 Nantucket Way
Middlebury, CT 06762

Mailing address

12 Nantucket Way
Middlebury, CT 06762-3348

Other providers in Middlebury, CT

All providers in Middlebury, CT · Dental Hygienist in Connecticut

Sources for this page

Verify at the official NPI Registry.