| NPI | 1558394049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY KATHLYN SMITH NELSON President 401-846-3214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: RI DEN 2287) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2020-08-22 |