Provider Demographics
NPI:1194747113
Name:MILLINGER, GARY STEVEN (DMD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:STEVEN
Last Name:MILLINGER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 WOODLAND ST.
Mailing Address - Street 2:SUITE 32
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105
Mailing Address - Country:US
Mailing Address - Phone:860-525-2366
Mailing Address - Fax:860-549-4280
Practice Address - Street 1:19 WOODLAND ST
Practice Address - Street 2:SUITE 32
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-2372
Practice Address - Country:US
Practice Address - Phone:860-525-2366
Practice Address - Fax:860-549-4280
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0061761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice