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Organization

RI DDS (ADIL)

Active
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Organization

RI DDS (ADIL)

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOHN MICROULIS (ADMINISTRATOR)
(401) 222-3182
Entity
Organization

Contact information

Practice address
8 OLIVE ST, PROVIDENCE, RI 02906-1310
(401) 861-2001
Mailing address
8 OLIVE ST, PROVIDENCE, RI 02906-1310
(401) 861-2001

Taxonomy

Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
MD04710
RI

Other

Enumeration date
07/13/2012
Last updated
07/13/2012
About Stedi
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  • Eligibility checks