Provider Demographics
NPI:1669548384
Name:REMIGINO, INGRID ANNA (DMD)
Entity type:Individual
Prefix:DR
First Name:INGRID
Middle Name:ANNA
Last Name:REMIGINO
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 1:35 PEARL ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051
Mailing Address - Country:US
Mailing Address - Phone:860-224-9956
Mailing Address - Fax:860-224-2511
Practice Address - Street 1:35 PEARL ST
Practice Address - Street 2:SUITE 202
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051
Practice Address - Country:US
Practice Address - Phone:860-224-9956
Practice Address - Fax:860-224-2511
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT76671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice