| Advanced Dentistry Of Rhode Island Llc | |
|
250 Wampanoag Trl Ste 103 Riverside RI 02915-2215 | |
| (401) 434-4413 | |
| Not Available |
| Full Name | Advanced Dentistry Of Rhode Island Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 250 Wampanoag Trl Ste 103, Riverside, Rhode Island |
| Authorized Official Name and Position | Ryan S Lee (PRESIDENT) |
| Authorized Official Contact | 6178330158 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Dentistry Of Rhode Island Llc 250 Wampanoag Trl Ste 103 Riverside RI 02915-2215 Ph: (401) 434-4413 | Advanced Dentistry Of Rhode Island Llc 250 Wampanoag Trl Ste 103 Riverside RI 02915-2215 Ph: (401) 434-4413 |
| NPI Number | 1467925529 |
|---|---|
| Provider Enumeration Date | 01/10/2019 |
| Last Update Date | 10/13/2020 |
| Medicare PECOS PAC ID | 3870913890 |
|---|---|
| Medicare Enrollment ID | O20201013002659 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467925529 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Ryan Lee |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1851698815 PECOS PAC ID: 4789004706 Enrollment ID: I20201014000187 |
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Riverside Family Dental, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1445 Wampanoag Trl Unit 209, Riverside, RI 02915 Phone: 401-433-2400 Fax: 401-433-2403 |