Organization
PETITO ORAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY ROCCO PETITO DDS MD (OWNER)
(401) 578-1688
Entity
Organization
Contact information
Practice address
400 MASSASOIT AVE, SUITE 103, EAST PROVIDENCE, RI 02914-2012
(401) 578-1866
(508) 336-6580
Mailing address
400 MASSASOIT AVE, SUITE 103, EAST PROVIDENCE, RI 02914-2012
(401) 578-1866
(508) 336-6580
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2552
RI
Other
Enumeration date
06/17/2011
Last updated
06/17/2011
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