| NPI | 1255076295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKIE ANDERSON Financial COO Rdinator 401-285-1188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2022-05-04 |
| Last Update Date | 2022-05-04 |