Provider Demographics
NPI:1396445607
Name:RANKIN, BRIGETTE ELIZABETH (DMD)
Entity type:Individual
Prefix:
First Name:BRIGETTE
Middle Name:ELIZABETH
Last Name:RANKIN
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 1:44 WARD ST APT 3
Mailing Address - Street 2:
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02127-3563
Mailing Address - Country:US
Mailing Address - Phone:603-991-6547
Mailing Address - Fax:
Practice Address - Street 1:800 TOLL GATE RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2721
Practice Address - Country:US
Practice Address - Phone:401-739-8337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN03745122300000X
MADEN100426122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist