| NPI | 1609553759 |
|---|---|
| Doing Business As | RESERVOIR DENTAL |
| Entity Type | Organization |
| Authorized Contact | VLAD BOTEZATU Dentist 401-400-8868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-06-30 |
| Last Update Date | 2023-06-30 |