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ADVANCED AESTHETIC DENTISTRY, PC

Dental Providers Dentist General Practice

Provider NPI: 1215078563

Organization Information:
Organization Name:  ADVANCED AESTHETIC DENTISTRY, PC
Authorized Official:  MOURAD  RAHIM  OWNER  401-596-7707

Practice Location:
85 BEACH ST BLDG. D WESTERLY, RI 02891-2717 US
Tel: 401-596-7707  Fax: 401-596-3645

Business Mailing Address:
85 BEACH ST BLDG. D WESTERLY, RI 02891-2717 US
Tel: 401-596-7707  Fax: 401-596-3645

NPI Information:
NPI: 1215078563
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
RIDEN02947

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 1223G0001X

Type:

Classification:



Definition:



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