Provider Demographics
NPI:1447652714
Name:BIANCAMANO, ANNE A (RDH, BSDH)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:A
Last Name:BIANCAMANO
Suffix:
Gender:F
Credentials:RDH, BSDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 HILLDALE RD
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-1411
Mailing Address - Country:US
Mailing Address - Phone:860-231-0085
Mailing Address - Fax:860-231-0085
Practice Address - Street 1:350 BARBOUR ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06120-1002
Practice Address - Country:US
Practice Address - Phone:860-695-5606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2782124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist