NPI 1033264866

David Ira Konicov, DDS

Practitioner Dentist Providence, RI

Practice location

Address: 189 Governor St Suite 201, Providence, RI 02906-3124
Phone: (401) 421-1457

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 1907 (RI)

Other Dentist providers in Rhode Island →

Registry record

NPI: 1033264866
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Jan 2007
Record last updated: 8 Jul 2007

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.