| NPI | 1497980924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN PAUL SHANNON Owner 401-596-8720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: RI 2263) |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2009-05-28 |