| NPI | 1215332077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN LEGASPI DOMINGUEZ Owner 401-766-9122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: RI DEN02402) |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2014-10-22 |