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Organization
BLACKSTONE VALLEY FAMILY DENTAL ASSOCIATES
Active
Organization
BLACKSTONE VALLEY FAMILY DENTAL ASSOCIATES
Active
Other names
ri dental
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENJAMIN RODRICK (EXECUTIVE ADMINISTRATOR)
(401) 450-2177
Entity
Organization
Contact information
Practice address
465 RESERVOIR AVE, CRANSTON, RI 02910-1728
(401) 450-2177
(401) 450-2779
Mailing address
465 RESERVOIR AVE, CRANSTON, RI 02910-1728
(401) 270-3997
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN0314
RI
Other
Enumeration date
07/22/2011
Last updated
07/22/2011
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