| NPI | 1548439417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY DOUGLAS LIGHT Principal 401-351-0072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: RI DEN2216) |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2008-02-26 |