Healthcare Provider Details

I. General information

NPI: 1578498697
Provider Name (Legal Business Name): MARGARET MIRABELLA-PIMER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 WEBSTER SQUARE RD
BERLIN CT
06037-2326
US

IV. Provider business mailing address

6 JUDITH CT
NORTHFORD CT
06472-1390
US

V. Phone/Fax

Practice location:
  • Phone: 860-321-6288
  • Fax:
Mailing address:
  • Phone: 203-415-7730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14821
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: