NPI 1588652697

Gwendolyn Basilica, RDH

Practitioner Dental Hygienist New London, CT

Practice location

Address: 1 Shaws Cv, New London, CT 06320-4902
Phone: (860) 444-0498
Mailing address: 54 Gardner Ave, New London, CT 06320-4313

Registered specialties

Dental Hygienist Primary

Dental Providers Taxonomy 124Q00000X Licence 002820 (CT)

Other Dental Hygienist providers in Connecticut →

Registry record

NPI: 1588652697
Entity type: Individual
Sex (as registered): Female
NPI issued: 12 Oct 2005
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.