Provider Demographics
NPI:1285294157
Name:MIGANI, ANDREW JOSEPH (DMD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:JOSEPH
Last Name:MIGANI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 DEBBY LN
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-1704
Mailing Address - Country:US
Mailing Address - Phone:203-903-3373
Mailing Address - Fax:
Practice Address - Street 1:622 HEBRON AVE STE 105
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-5003
Practice Address - Country:US
Practice Address - Phone:860-633-1809
Practice Address - Fax:860-633-6406
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT125431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice