Organization
HARBORSIDE FAMILY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SAMANTHA BURNELL (CHIEF OPERATIONS OFFICER)
(401) 578-0274
Entity
Organization
Contact information
Practice address
600 WAMPANOAG TRL, RIVERSIDE, RI 02915-1511
(401) 431-2180
Mailing address
600 WAMPANOAG TRL, RIVERSIDE, RI 02915-1511
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/07/2017
Last updated
09/07/2017
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