Individual
DR. JAMIE MICHELE ITALIANE-DECUBELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
325 S MAIN ST, COVENTRY, RI 02816-5911
(401) 828-7070
(401) 828-7125
Mailing address
325 S MAIN ST, COVENTRY, RI 02816-5911
(401) 828-7070
(401) 828-7125
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
02807
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202020448
FEDERAL ID
RI
Enumeration date
12/16/2005
Last updated
12/15/2008
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