David Ira Konicov, DDS

NPI #1033264866 in Providence, Rhode Island

Provider Information

NPI Number
1033264866
Entity Type
Individual
Name
David Ira Konicov, DDS
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Dentist
Credential
DDS
Enumeration Date
Jan 24, 2007
Last Updated
Jul 8, 2007

Practice Location

Address
189 GOVERNOR ST
Address 2
SUITE 201
ZIP Code
02906-3124
Phone
(401) 421-1457

Specialties & Taxonomy Codes

Specialty
Dentist

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