| NPI | 1588835623 |
|---|---|
| Doing Business As | WELLONE PRIMARY MEDICAL AND DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | PETER BANCROFT CEO 401-568-7661 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: RI ACF01571) |
| Additional Taxonomies | 122300000X Dentist (Licence: RI ACF01571) |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2012-06-01 |