Provider Demographics
NPI:1952322620
Name:GHENTA-DRIMBAREAN, ANDREA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:GHENTA-DRIMBAREAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:GHENTA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS PC
Mailing Address - Street 1:346 RUMSTICK RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806
Mailing Address - Country:US
Mailing Address - Phone:401-245-4632
Mailing Address - Fax:
Practice Address - Street 1:767 MAIN RD
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:MA
Practice Address - Zip Code:02790
Practice Address - Country:US
Practice Address - Phone:508-636-6566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA195201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice