| NPI | 1477736452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CIELITO R DEAYALA Manager 401-942-5051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: RI DEN02637) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: RI DEN02737) |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2007-12-12 |