# ORAL MAXILLOFACIAL SURGERY AND DENTAL IMPLANT CENTER PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306681788
- **Authorized official:** MRS. VALERIE MERCER (BILLING & ADMINISTRATIVE MANAGER)
- **Authorized official phone:** (401) 595-5369

## Contact information

- **Practice address:** 65 W MAIN RD, MIDDLETOWN, RI 02842-4933
- **Practice address phone:** (401) 848-0070
- **Practice address fax:** (401) 848-2225
- **Mailing address:** 65 W MAIN RD, MIDDLETOWN, RI 02842-4933
- **Mailing address phone:** (401) 848-0070
- **Mailing address fax:** (401) 848-2225

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 06/27/2024
- **Last updated:** 06/27/2024