MEDICARE: GINGER M POLLACK DMD PC

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	1223G0001X	General Practice Dentistry	8985	CT

General Provider Information

NPI Number	:	1881748739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GINGER M POLLACK DMD PC

Provider Business Mailing Address
First Line	:	PO BOX 9488
Second Line	:
City	:	BOLTON
State	:	CT
Zip	:	06043
Country	:	US
Telephone Number	:	860-646-0773
Fax Number	:	860-647-6915

Provider Business Practice Location Address
First Line	:	665 BOSTON TURNPIKE
Second Line	:
City	:	BOLTON
State	:	CT
Zip	:	06043
Country	:	US
Telephone Number	:	860-646-0773
Fax Number	:	860-647-6915

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GINGER M POLLACK
Credential	:	DMD
Telephone Number	:	860-646-0773

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	03/08/2012

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