| NPI | 1518191170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN PATRICK HAGERTY Owner 401-884-4874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: RI 2155) |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2009-05-12 |