| NPI | 1699063099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW BRIAN CAPALBO Owner 401-789-9718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: RI 2931) |
| Additional Taxonomies | 122300000X Dentist (Licence: RI 2981) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2011-07-20 |