Smith Family Dental Assoc | |
2780 Pawtucket Avenue East Providence RI 02914 | |
(401) 434-7471 | |
(401) 431-0591 |
Full Name | Smith Family Dental Assoc |
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Speciality | Dentist |
Location | 2780 Pawtucket Avenue, East Providence, Rhode Island |
Authorized Official Name and Position | Michelle Smith Goncalves (PRESIDENT) |
Authorized Official Contact | 4014347471 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Smith Family Dental Assoc 2780 Pawtucket Avenue East Providence RI 02914 Ph: (401) 434-7471 | Smith Family Dental Assoc 2780 Pawtucket Avenue East Providence RI 02914 Ph: (401) 434-7471 |
NPI Number | 1972702173 |
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Provider Enumeration Date | 07/17/2007 |
Last Update Date | 07/17/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972702173 | NPI | - | NPPES |
MS30181 | Medicaid | RI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | DEN01418 (Rhode Island) | Primary |
Smith Family Dental Assoc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2780 Pawtucket Ave, East Providence, RI 02915 Phone: 401-434-7471 Fax: 401-431-0591 | |
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