| NPI | 1619275914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN L RODRICK President 4014-502-1277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: RI den03092) |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2011-03-10 |