Organization
NEW HAVEN DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY GIBSON (ADMINISTRATOR)
(203) 781-8051
Entity
Organization
Contact information
Practice address
123 YORK ST, SUITE 4L, NEW HAVEN, CT 06511-5614
(230) 781-8051
(203) 781-8089
Mailing address
123 YORK ST, SUITE 4L, NEW HAVEN, CT 06511-5614
(230) 781-8051
(203) 781-8089
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/07/2007
Last updated
06/27/2012
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