Provider Demographics
NPI:1295889897
Name:GARY S. MILLINGER, PC
Entity type:Organization
Organization Name:GARY S. MILLINGER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:S
Authorized Official - Last Name:MILLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:860-525-2366
Mailing Address - Street 1:19 WOODLAND ST
Mailing Address - Street 2:SUITE 32
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-2372
Mailing Address - Country:US
Mailing Address - Phone:860-525-2366
Mailing Address - Fax:860-549-4280
Practice Address - Street 1:19 WOODLAND ST
Practice Address - Street 2:SUITE 32
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-2372
Practice Address - Country:US
Practice Address - Phone:860-525-2366
Practice Address - Fax:860-549-4280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT61761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty