Provider Demographics
NPI:1295749489
Name:GOMEZ, NORMA (DDS)
Entity type:Individual
Prefix:DR
First Name:NORMA
Middle Name:
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-1312
Mailing Address - Country:US
Mailing Address - Phone:203-234-3900
Mailing Address - Fax:203-234-3941
Practice Address - Street 1:521 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-1312
Practice Address - Country:US
Practice Address - Phone:203-234-3900
Practice Address - Fax:203-234-3941
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0092561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice