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593 Eddy St Providence RI 02903-4923 | |
| (401) 444-4312 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 593 Eddy St, Providence, Rhode Island |
| Authorized Official Name and Position | Peter K Markell (EVP & CFO) |
| Authorized Official Contact | 4014447914 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
117 Ellenfield St Ste 101 Providence RI 02905-4541 Ph: (401) 444-6779 | 593 Eddy St Providence RI 02903-4923 Ph: (401) 444-4312 |
| NPI Number | 1770601668 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 04/05/2023 |
| Medicare PECOS PAC ID | 8921900044 |
|---|---|
| Medicare Enrollment ID | O20120705000002 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770601668 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Milton Liu |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1326359266 PECOS PAC ID: 9830498039 Enrollment ID: I20211111002465 |
| Provider Name | Joseph Anthony Manzella |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1336718428 PECOS PAC ID: 2769883032 Enrollment ID: I20240109001342 |
| Provider Name | Sara M Dinardo |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1548609357 PECOS PAC ID: 2668779265 Enrollment ID: I20240122001286 |
| Provider Name | George Joseph Dupont |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1689726762 PECOS PAC ID: 4981056355 Enrollment ID: I20240122002212 |
| Provider Name | Eileen M Danaher |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1376982181 PECOS PAC ID: 2264739846 Enrollment ID: I20240126002549 |
| Provider Name | Elizabeth G Benz |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1760779516 PECOS PAC ID: 3375840507 Enrollment ID: I20240207003914 |
Angell Street Dental Associates, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 425 Angell St, Providence, RI 02906 Phone: 401-272-2331 Fax: 401-272-2361 | |
Sunnyside Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 381 Angell St, Providence, RI 02906 Phone: 401-272-4900 Fax: 401-272-5989 | |
Cityline Dental Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Reservoir Ave, Suite 3d, Providence, RI 02907 Phone: 401-941-3353 Fax: 401-461-6558 | |
Zumstein Family Dentistry, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 159 Governor St, Providence, RI 02906 Phone: 401-274-1140 | |
Boustani Periodontics Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 40 Elmgrove Ave, Providence, RI 02906 Phone: 401-421-1717 Fax: 401-421-0066 | |
Celestial Smile Dental Associates Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 Dorrance St Ste 700, Providence, RI 02903 Phone: 781-774-9885 |