Gail E Bodzioch, DMD
Individual provider Active NPI Dentist · Rocky Hill, CT
NPI 1891911525 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1891911525
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 006854 (CT)
- Practice address
- 412 Cromwell Ave
Rocky Hill, CT 06067-1834 - Phone
- (860) 563-1294
- Fax
- (860) 563-1294
- NPI assigned
- Apr 18, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006854 | CT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael R Gabor DMD, PC | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 006854 | CT | Yes |
Addresses
Primary practice location
412 Cromwell Ave
Rocky Hill, CT 06067-1834
Mailing address
PO Box 711
Rocky Hill, CT 06067-0711
Phone (860) 563-1295
Other providers in Rocky Hill, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.