Organization
MICHAEL M. GOODING DMD L.T.D
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELISSA MARIE JUBINVILLE (OFFICE MANAGER)
(401) 463-7678
Entity
Organization
Contact information
Practice address
1422 WARWICK AVE, WARWICK, RI 02888-5026
(401) 463-7678
(401) 463-3897
Mailing address
1422 WARWICK AVE, WARWICK, RI 02888-5026
(401) 463-7678
(401) 463-3897
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407997687
PERSONAL NPI
RI
01
—
1700362639
PERSONAL NPI MIA GOODING
RI
Enumeration date
09/10/2018
Last updated
02/21/2020
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