Individual
DR. JONATHAN BRUCE VANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
38 STATE ST, WARREN, RI 02885-3128
(401) 245-6131
(401) 245-5152
Mailing address
38 STATE ST, WARREN, RI 02885-3128
(401) 245-6131
(401) 245-5152
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN02726
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14466-1
UHC DENTAL
RI
01
—
610890
UNITED CONCORDIA
RI
01
—
83816
BLUE CROSS RI
RI
05
—
JB00754
—
RI
01
—
RG0041
BLUE CROSS MA
MA
Enumeration date
05/01/2007
Last updated
07/09/2007
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