MEDICARE: BONNIE GIARDINI RDH, BS

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
1	124Q00000X	Dental Hygienist	002546	CT

General Provider Information

NPI Number	:	1770550717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BONNIE GIARDINI RDH, BS

Provider Business Mailing Address
First Line	:	62 APPLE HL
Second Line	:
City	:	WETHERSFIELD
State	:	CT
Zip	:	06109-3502
Country	:	US
Telephone Number	:	860-529-8894
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 MERCER AVE
Second Line	:
City	:	EAST HARTFORD
State	:	CT
Zip	:	06118-1517
Country	:	US
Telephone Number	:	860-622-5514
Fax Number	:	860-568-2490

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	07/09/2007

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