Provider Demographics
NPI:1194071548
Name:MILLS AND GHENTA, DDS PC
Entity type:Organization
Organization Name:MILLS AND GHENTA, DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:DRIMBAREAN-GHENTA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:508-997-6617
Mailing Address - Street 1:346 RUMSTICK RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-4926
Mailing Address - Country:US
Mailing Address - Phone:401-289-2446
Mailing Address - Fax:
Practice Address - Street 1:516 HAWTHORN ST STE 2
Practice Address - Street 2:
Practice Address - City:DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-3733
Practice Address - Country:US
Practice Address - Phone:508-997-6617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-02
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA195201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty