| NPI | 1285966481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM MICHAEL GORDON Orthodontist 401-828-1171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2010-02-12 |
| Last Update Date | 2011-01-31 |