Provider Demographics
NPI:1124359328
Name:GOPALAKRISHNA, AADARSH (DDS, MS,)
Entity Type:Individual
Prefix:
First Name:AADARSH
Middle Name:
Last Name:GOPALAKRISHNA
Suffix:
Gender:M
Credentials:DDS, MS,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 FARMINGTON AVE
Mailing Address - Street 2:RECONSTRUCTIVE SCIENCES
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1956
Mailing Address - Country:US
Mailing Address - Phone:860-679-8027
Mailing Address - Fax:860-679-1370
Practice Address - Street 1:263 FARMINGTON AVE
Practice Address - Street 2:RECONSTRUCTIVE SCIENCES
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1956
Practice Address - Country:US
Practice Address - Phone:860-679-8027
Practice Address - Fax:860-679-1370
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT010167122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist