Provider Demographics
NPI:1235283698
Name:VATAFU, GABRIELA (DDS)
Entity Type:Individual
Prefix:MRS
First Name:GABRIELA
Middle Name:
Last Name:VATAFU
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 1:10 THORNBUSH RD
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-3554
Mailing Address - Country:US
Mailing Address - Phone:860-257-4174
Mailing Address - Fax:
Practice Address - Street 1:122 PROSPECT HILL RD
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06088
Practice Address - Country:US
Practice Address - Phone:860-292-6600
Practice Address - Fax:860-292-8811
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT009515122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist