| NPI | 1063433209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK H MCMILLEN Owner 401-331-7171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: RI DEN0149) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2009-11-11 |