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General NPI Number Information
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NPI Number | 1740382845
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Entity Type | Individual
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Provider Name | CHARLES F GUELAKIS D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 02/16/2011
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Provider Practice Location Address
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Address Line | 1122 HIGHLAND AVENUE
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City | CHESHIRE
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State | CT
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Zip | 06410-1654
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Country | US
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Telephone | 203-272-9960
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Fax | 208-699-9403
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Provider Business Mailing Address
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Address Line | 1122 HIGHLAND AVENUE
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City | CHESHIRE
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State | CT
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Zip | 06410-1654
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Country | US
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Telephone | 203-272-9960
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Fax | 208-699-9403
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 4174
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 4174
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License Number State | CT
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