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Individual

MATTHEW D FREITAS

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/ ATTN: R. SOARES, PROVIDENCE, RI 02908-4728
(401) 456-2525
(401) 456-6742

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
LD0071
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LD0071
LICENSE
RI
Enumeration date
07/27/2011
Last updated
07/27/2011
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