| NPI | 1306681788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE MERCER Billing & Administrative Manager 401-595-5369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2024-06-27 |
| Last Update Date | 2024-06-27 |