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BLACKSTONE VALLEY FAMILY DENTAL ASSOC.PC

Dental Providers Dentist General Practice

Provider NPI: 1912025305

Organization Information:
Organization Name:  BLACKSTONE VALLEY FAMILY DENTAL ASSOC.PC
Organization is not Subpart
Authorized Official:  CHUN-KUEI  CHEN  DENTIST  401-722-4086

Practice Location:
1044 BROAD ST  CENTRAL FALLS, RI 02863-1507 US
Tel: 401-793-6352  Fax: --

Business Mailing Address:
PO BOX 5646  PAWTUCKET, RI 02862-5646 US
Tel: 401-793-6352  Fax: 401-722-4086

NPI Information:
NPI: 1912025305
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
RI02857

Other Provider Identifiers:

IssuerNumberStateType
BCBS OF RI8627-3RI01
DELTAL DENTAL INS.02857RI01



American Medical Association 2012 taxonomy code information

Code: 1223G0001X

Type:

Classification:



Definition:



MEDICAL JOBS RI - Page 1

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