| NPI | 1609279835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY L FUGATE Pediatric Dentist 401-378-3720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA DN1855409) |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2014-10-02 |