NPI 1013164920

The Family Dentist

Organisation Dentist Pawtucket, RI

Practice location

Address: 480 Broadway, Pawtucket, RI 02860-1340
Phone: (401) 728-6654
Fax: (401) 728-5726

Authorised official

Name: Michael A. Wagner
Title: President
Phone: (401) 728-6654

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 2342 (RI)

Other Dentist providers in Rhode Island →

Registry record

NPI: 1013164920
Entity type: Organization
NPI issued: 21 Aug 2008
Record last updated: 21 Aug 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.