| NPI | 1336398676 |
|---|---|
| Former Legal Business Name | PERIODONTOLOGY ASSOCIATES LTD |
| Entity Type | Organization |
| Authorized Contact | RICHARD L GLICK President 401-943-6311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2016-03-03 |