Provider Demographics
NPI:1295010965
Name:CAWTHON-GILLESPIE, KAREN MARIE (RDH)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:MARIE
Last Name:CAWTHON-GILLESPIE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:469 MIGEON AVE
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-4643
Mailing Address - Country:US
Mailing Address - Phone:860-489-0931
Mailing Address - Fax:860-489-3325
Practice Address - Street 1:469 MIGEON AVE
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-4643
Practice Address - Country:US
Practice Address - Phone:860-489-0931
Practice Address - Fax:860-489-3325
Is Sole Proprietor?:No
Enumeration Date:2011-10-13
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005939124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist