Individual
GAETAN DONALD CHARBONNEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
24 SALT POND RD SUITE A2, SOUTH KINGSTOWN OFFICE PARK, WAKEFIELD, RI 02879
(401) 783-4223
(401) 783-1228
Mailing address
24 SALT POND RD SUITE A2, SOUTH KINGSTOWN OFFICE PARK, WAKEFIELD, RI 02879
(401) 783-4223
(401) 783-1228
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN01889
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84185
BLUE CROSS DENTAL
RI
Enumeration date
08/05/2006
Last updated
07/08/2007
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