| NPI | 1124278247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE ANTHONY LABORE President/Owner 401-846-6265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: RI 1518) |
| Additional Taxonomies | 122300000X Dentist (Licence: RI 1600) |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2008-09-25 |