| NPI | 1790016103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH L DISANO Owner 401-789-8693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: RI 1457) |
| Additional Taxonomies | 122300000X Dentist (Licence: RI 2746) |
| Enumeration Date | 2010-01-25 |
| Last Update Date | 2010-01-25 |