| NPI | 1457482820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ANN DELCUPOLO Sec 401-861-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: RI 02010) |
| Additional Taxonomies | 1223P0300X Dentist Periodontics (Licence: RI 02496) |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: RI 02728) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |