| NPI | 1891997490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLEY RADTKE Office Manager 401-295-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: RI RI002894) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2020-08-22 |