Individual
ENIO GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
428 COLUMBUS AVE, NEW HAVEN, CT 06519-1233
(203) 503-3040
(203) 503-3187
Mailing address
400 COLUMBUS AVE, NEW HAVEN, CT 06519-1233
(203) 503-3174
(203) 503-3183
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
7865
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004235893
—
CT
Enumeration date
09/09/2016
Last updated
10/07/2016
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