Provider Demographics
NPI:1124078290
Name:WEINSTEIN, GERALDINE M (DDS)
Entity type:Individual
Prefix:DR
First Name:GERALDINE
Middle Name:M
Last Name:WEINSTEIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:GERALDINE
Other - Middle Name:
Other - Last Name:MUNSAYAC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:263 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-3905
Mailing Address - Country:US
Mailing Address - Phone:860-679-2207
Mailing Address - Fax:860-679-1899
Practice Address - Street 1:263 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-3905
Practice Address - Country:US
Practice Address - Phone:860-679-2207
Practice Address - Fax:860-679-1899
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT117611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice