Provider Demographics
NPI:1174731608
Name:PRIGNANO, JOSEPH A (DDS)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
Last Name:PRIGNANO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 209
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:CT
Mailing Address - Zip Code:06447-0209
Mailing Address - Country:US
Mailing Address - Phone:860-295-9536
Mailing Address - Fax:860-295-8847
Practice Address - Street 1:ROUTE 66, 14 EAST HAMPTON ROAD
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:CT
Practice Address - Zip Code:06424
Practice Address - Country:US
Practice Address - Phone:860-295-9536
Practice Address - Fax:860-295-8847
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0045331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice