| NPI | 1639564891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NELFA M CESPEDES Owner 401-781-4424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: RI 3210) |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2024-08-16 |