Provider Demographics
NPI:1407221377
Name:SERRENHO, ANA (DMD)
Entity type:Individual
Prefix:DR
First Name:ANA
Middle Name:
Last Name:SERRENHO
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 1:75 POST OFFICE PARK STE 7507
Mailing Address - Street 2:
Mailing Address - City:WILBRAHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01095-1189
Mailing Address - Country:US
Mailing Address - Phone:413-685-7570
Mailing Address - Fax:
Practice Address - Street 1:75 POST OFFICE PARK STE 7507
Practice Address - Street 2:
Practice Address - City:WILBRAHAM
Practice Address - State:MA
Practice Address - Zip Code:01095-1189
Practice Address - Country:US
Practice Address - Phone:413-685-7570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18562501223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics