Provider Demographics
NPI:1770550717
Name:GIARDINI, BONNIE (RDH, BS)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:GIARDINI
Suffix:
Gender:F
Credentials:RDH, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 APPLE HL
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-3502
Mailing Address - Country:US
Mailing Address - Phone:860-529-8894
Mailing Address - Fax:
Practice Address - Street 1:15 MERCER AVE
Practice Address - Street 2:
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06118-1517
Practice Address - Country:US
Practice Address - Phone:860-622-5514
Practice Address - Fax:860-568-2490
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002546124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist