31 Elmgrove Dental LLC
NPI #1225787708 in Providence, Rhode Island
Provider Information
- NPI Number
- 1225787708
- Entity Type
- Organization
- Organization Name
- 31 Elmgrove Dental LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Mar 22, 2022
- Last Updated
- Mar 22, 2022
Practice Location
- Address
- 31 ELMGROVE AVE
- City
- Providence
- State
- Rhode Island
- ZIP Code
- 02906-4103
- Phone
- (401) 421-9350
Authorized Official
- Name
- MRS. JESSICA A POLAK, CDA
- Title
- OFFICE MANAGER
- Phone
- (401) 421-9350
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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