| NPI | 1861585671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BRIAN FORMAN President 401-766-8600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: RI dn2031) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-08-22 |