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NPI Code Detail

MEDICARE: LAXMI GURUNG RDH

MEDICARE:   LAXMI  GURUNG  RDH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1124Q00000XDental Hygienist007124CT

General Provider Information

NPI Number : 1144412008
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAXMI GURUNG RDH
Provider Business Mailing Address
First Line : 635 MAIN ST
Second Line : ATTN: CREDENTIALING DEPT
City : MIDDLETOWN
State : CT
Zip : 06457-2718
Country : US
Telephone Number : 860-347-6971
Fax Number : 860-638-6601
Provider Business Practice Location Address
First Line : 141 FRANKLIN ST
Second Line :
City : STAMFORD
State : CT
Zip : 06901-1014
Country : US
Telephone Number : 203-969-0802
Fax Number : 203-326-2990
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2007
Last Update Date : 08/15/2007

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Directions to “ LAXMI GURUNG RDH” Practice Location

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