| NPI | 1679634109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX HODOSH Dr. Manager 401-467-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: RI 2280) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: RI 1854) |
| 1223G0001X Dentist, General Practice (Licence: RI 2280) | |
| 1223G0001X Dentist, General Practice (Licence: RI 1854) | |
| 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: RI 2280) | |
| 1223P0300X Dentist, Periodontics (Licence: RI 2280) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: RI 2280) | |
| 122400000X Denturist (Licence: RI 2280) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2009-05-26 |