NPI | 1285692731 |
---|---|
Entity Type | Organization |
Authorized Contact | STEPHEN NICHOLAS BAKIAS Owner 401-435-4240 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: RI 1686) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MA 16987) |
Enumeration Date | 2006-05-03 |
Last Update Date | 2008-04-20 |