| Glenn L. Dominguez, D.m.d., Llc | |
|
219 Cass Ave Suite E Woonsocket RI 02895-4736 | |
| (401) 766-9122 | |
| (401) 766-1110 |
| Full Name | Glenn L. Dominguez, D.m.d., Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 219 Cass Ave, Woonsocket, Rhode Island |
| Authorized Official Name and Position | Glenn Legaspi Dominguez (OWNER) |
| Authorized Official Contact | 4017669122 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glenn L. Dominguez, D.m.d., Llc 219 Cass Ave Suite E Woonsocket RI 02895-4736 Ph: (401) 766-9122 | Glenn L. Dominguez, D.m.d., Llc 219 Cass Ave Suite E Woonsocket RI 02895-4736 Ph: (401) 766-9122 |
| NPI Number | 1215332077 |
|---|---|
| Provider Enumeration Date | 10/22/2014 |
| Last Update Date | 10/22/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215332077 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DEN02402 (Rhode Island) | Primary |
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