| NPI | 1457522989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CKARLA AGUDELO Director Of Credentialing 401-767-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: RI ACF01569) |
| Enumeration Date | 2008-03-12 |
| Last Update Date | 2025-04-04 |