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1588140818
PROVIDENCE DENTAL GROUP, LLC
PROVIDENCE, RI
NPI
1588140818
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Entity Type
Organization
Authorized Contact
RICHARD TODD MILLER
President
781-562-0457
Organization Subpart ?
No
Primary Taxonomy
122300000X Dentist
Enumeration Date
2018-07-19
Last Update Date
2018-07-19
Business Address
PROVIDENCE DENTAL GROUP, LLC
200 WATERMAN ST
PROVIDENCE, RI 02906-4039
Phone number: 401-421-2022
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Mailing Address
PROVIDENCE DENTAL GROUP, LLC
500 CHAPMAN ST UNIT 201
CANTON, MA 02021-2040
Phone number: 617-383-6687
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