Provider Demographics
NPI:1255661963
Name:COFRANCESCO, DONNA LYNN (RDH)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:LYNN
Last Name:COFRANCESCO
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:QUERA
Other - Last Name:COFRANCESCO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RDH
Mailing Address - Street 1:280 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:EAST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06512
Mailing Address - Country:US
Mailing Address - Phone:203-467-1681
Mailing Address - Fax:203-466-2273
Practice Address - Street 1:280 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06512
Practice Address - Country:US
Practice Address - Phone:203-467-1681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-31
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003424124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist