Provider Demographics
NPI:1790965879
Name:GJERTSEN, ANJANETTE W (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ANJANETTE
Middle Name:W
Last Name:GJERTSEN
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10 BERKELEY ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-3915
Mailing Address - Country:US
Mailing Address - Phone:203-899-1636
Mailing Address - Fax:203-899-1631
Practice Address - Street 1:10 BERKELEY ST
Practice Address - Street 2:SUITE 4
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-3915
Practice Address - Country:US
Practice Address - Phone:203-899-1636
Practice Address - Fax:203-899-1631
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0097401223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics