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General NPI Number Information
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NPI Number | 1356435077
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Entity Type | Individual
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Provider Name | B GAIL DEMKO DMD,
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 07/30/2013
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Provider Practice Location Address
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Address Line | 140 MERRIAM ST
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City | WESTON
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State | MA
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Zip | 02493-1319
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Country | US
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Telephone | 617-964-4028
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Fax | 617-595-4591
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Provider Business Mailing Address
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Address Line | PO BOX 606
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City | WESTON
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State | MA
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Zip | 02493-0004
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Country | US
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Telephone | 617-964-4028
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Fax | 617-595-4591
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | 14113
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | 12010332A
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License Number State | MI
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