Individual
DR. GREGORY MICHAEL KRACZKOWSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
17 LAFAYETTE ST, NORWICH, CT 06360-3407
(860) 886-2497
Mailing address
17 LAFAYETTE ST, NORWICH, CT 06360-3407
(860) 886-2497
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11253
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004011136
—
CT
05
—
004011367
—
CT
Enumeration date
06/26/2013
Last updated
06/30/2016
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