| NPI | 1093889800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE L COUTURE Office Manager 401-732-1188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: RI 2217) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-08-22 |