Provider Demographics
NPI:1801880430
Name:GAMBARDELLA, RAYMOND J (DMD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:J
Last Name:GAMBARDELLA
Suffix:
Gender:M
Credentials:DMD
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Mailing Address - Street 1:87 STATE ST
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2723
Mailing Address - Country:US
Mailing Address - Phone:203-453-4381
Mailing Address - Fax:203-458-5085
Practice Address - Street 1:2560 DIXWELL AVENUE
Practice Address - Street 2:SUITE 2A
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514
Practice Address - Country:US
Practice Address - Phone:203-281-3737
Practice Address - Fax:203-230-2931
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2014-04-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT43671223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery