Provider Demographics
NPI:1578289112
Name:BENGHIAC, ANA-GABRIELA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANA-GABRIELA
Middle Name:
Last Name:BENGHIAC
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 BOYLSTON ST APT 5F
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02199-7905
Mailing Address - Country:US
Mailing Address - Phone:781-473-3893
Mailing Address - Fax:
Practice Address - Street 1:790 BOYLSTON ST APT 5F
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02199-7905
Practice Address - Country:US
Practice Address - Phone:781-473-3893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1859639122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist