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1982810214
SCOTT MARK FERTIK
PROVIDENCE, RI
NPI
1982810214
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223P0300X Dentist Periodontics
(Licence: RI DEN02345)
Enumeration Date
2007-05-15
Last Update Date
2007-07-08
Business Address
DR. SCOTT MARK FERTIK DDS
167 GANO ST
PROVIDENCE, RI 02906-3808
Phone number: 401-274-2600
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Mailing Address
DR. SCOTT MARK FERTIK DDS
55 SIGNAL RIDGE WAY
E GREENWICH, RI 02818-1649
Phone number: 401-886-7999
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