Provider Demographics
NPI:1326299934
Name:HAROIAN, GREGORY B (DMD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:B
Last Name:HAROIAN
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 1:479 BUCKLAND RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-3739
Mailing Address - Country:US
Mailing Address - Phone:860-648-4471
Mailing Address - Fax:860-648-0181
Practice Address - Street 1:479 BUCKLAND RD
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-3739
Practice Address - Country:US
Practice Address - Phone:860-648-4471
Practice Address - Fax:860-648-0181
Is Sole Proprietor?:No
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT63501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice