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
- City
- Providence
- State
- Rhode Island
- ZIP Code
- 02906-3124
- Phone
- (401) 421-1457
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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