| |
1196 Smith St Providence RI 02908-2036 | |
(401) 351-3090 | |
(401) 331-1315 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 1196 Smith St, Providence, Rhode Island |
Authorized Official Name and Position | Kristofer Haggarty (MEMBER) |
Authorized Official Contact | 4013513090 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1196 Smith St Providence RI 02908-2036 Ph: (401) 351-3090 | 1196 Smith St Providence RI 02908-2036 Ph: (401) 351-3090 |
NPI Number | 1750680435 |
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Provider Enumeration Date | 03/21/2011 |
Last Update Date | 03/21/2011 |
Identifier | Type | State | Issuer |
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1750680435 | NPI | - | NPPES |
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