| NPI | 1831255405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL J. MATRULLO Owner 401-943-0644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: RI 1745) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: RI 2839) |
| 1223G0001X Dentist General Practice (Licence: RI 2842) | |
| 1223P0300X Dentist Periodontics (Licence: RI 2637) | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2020-08-22 |