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1033264866
DAVID IRA KONICOV
PROVIDENCE, RI
NPI
1033264866
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: RI 1907)
Enumeration Date
2007-01-24
Last Update Date
2007-07-08
Business Address
DAVID IRA KONICOV DDS
189 GOVERNOR ST SUITE 201
PROVIDENCE, RI 02906-3124
Phone number: 401-421-1457
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Mailing Address
DAVID IRA KONICOV DDS
189 GOVERNOR ST SUITE 201
PROVIDENCE, RI 02906-3124
Phone number: 401-421-1457
Copy
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