| Petito Oral Surgery | |
|
400 Massasoit Ave Suite 103 East Providence RI 02914-2012 | |
| (401) 578-1866 | |
| (508) 336-6580 |
| Full Name | Petito Oral Surgery |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 400 Massasoit Ave, East Providence, Rhode Island |
| Authorized Official Name and Position | Anthony Rocco Petito (OWNER) |
| Authorized Official Contact | 4015781688 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Petito Oral Surgery 400 Massasoit Ave Suite 103 East Providence RI 02914-2012 Ph: (401) 578-1866 | Petito Oral Surgery 400 Massasoit Ave Suite 103 East Providence RI 02914-2012 Ph: (401) 578-1866 |
| NPI Number | 1134414154 |
|---|---|
| Provider Enumeration Date | 06/17/2011 |
| Last Update Date | 06/17/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134414154 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 2552 (Rhode Island) | Primary |
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