Individual
DR. REYNALDO PUERTOLLANO BADUYA SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
252 ADELAIDE AVE, PROVIDENCE, RI 02907-1833
(401) 941-2600
(401) 941-2695
Mailing address
252 ADELAIDE AVE, PROVIDENCE, RI 02907-1833
(401) 941-2600
(401) 941-2695
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN02491
RI
Other
Enumeration date
12/05/2006
Last updated
07/08/2007
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