Individual
LORI GALLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
763 BURNSIDE AVE, EAST HARTFORD, CT 06108-2791
(860) 291-9728
(860) 291-9728
Mailing address
43 CHENEY LN, NEWINGTON, CT 06111-3112
(860) 667-4425
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
007380
CT
Other
Enumeration date
05/01/2014
Last updated
05/01/2014
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