| Wickford Orthodontics | |
|
320 Phillips St Suite 202 North Kingstown RI 02852-5149 | |
| (401) 295-2700 | |
| Not Available |
| Full Name | Wickford Orthodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 320 Phillips St, North Kingstown, Rhode Island |
| Authorized Official Name and Position | Kelley Radtke (OFFICE MANAGER) |
| Authorized Official Contact | 4012952700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wickford Orthodontics 320 Phillips St Suite 202 North Kingstown RI 02852-5149 Ph: (401) 295-2700 | Wickford Orthodontics 320 Phillips St Suite 202 North Kingstown RI 02852-5149 Ph: (401) 295-2700 |
| NPI Number | 1891997490 |
|---|---|
| Provider Enumeration Date | 06/05/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891997490 | NPI | - | NPPES |
| SW60095 | Medicaid | RI | |
| WO60094 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | RI002894 (Rhode Island) | Primary |
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