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General NPI Number Information
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NPI Number | 1376836742
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Entity Type | Organization
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Legal Business Name | NORMA GOMEZ DDS AND ASSOCIATES LLC
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Dates
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Enumeration Date | 05/18/2011
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Last Update Date | 09/08/2015
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Provider Practice Location Address
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Address Line | 144 N MAIN ST STE 8
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City | BRANFORD
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State | CT
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Zip | 06405-3044
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Country | US
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Telephone | 203-481-0338
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Fax | 203-481-0339
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Provider Business Mailing Address
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Address Line | 144 N MAIN ST STE 8
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City | BRANFORD
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State | CT
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Zip | 06405-3044
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Country | US
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Telephone | 203-481-0338
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Fax | 203-481-0339
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. LINA VELEZ
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Credential |
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Telephone | 203-481-0338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 261QD0000X
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 9256
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 9256
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 9256
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License Number State | CT
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Taxonomy #5
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 010722
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License Number State | CT
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