Gil David Boisoneau, DDS

Individual provider Active NPI General Practice Dentistry · Manchester, CT

NPI 1578612909 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1578612909
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
3810 (CT)
Practice address
229 E Center St
Manchester, CT 06040-5207
Phone
(860) 643-0688
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3810 CT Yes

Addresses

Primary practice location

229 E Center St
Manchester, CT 06040-5207

Mailing address

229 E Center St
Manchester, CT 06040-5207
Phone (860) 643-0688

Other providers in Manchester, CT

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

Sources for this page

Verify at the official NPI Registry.