Individual
ELLIOT CHIU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
21 PEACE ST, ST. JOSEPH PEDI. DENTAL, PROVIDENCE, RI 02907-1510
(401) 456-4441
(401) 456-4089
Mailing address
825 CHALKSTONE AVE, N. CAMPUS BUSINESS OFFICE /ATT: R SOARES, PROVIDENCE, RI 02908-4728
(401) 456-2525
(401) 456-6742
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
LD0073
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LD0073
LICENSE
RI
Enumeration date
07/27/2011
Last updated
07/27/2011
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