| NPI | 1629353552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA J KORUS Office Manager 401-884-5242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: RI 02460) |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2011-10-11 |