Individual
MARTIN T ELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1265 RESERVOIR AVE, CRANSTON, RI 02920-6060
(401) 464-6406
(401) 464-6466
Mailing address
1265 RESERVOIR AVE, CRANSTON, RI 02920-6060
(401) 464-6406
(401) 464-6466
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2506
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ME1187
—
RI
Enumeration date
02/06/2006
Last updated
06/05/2023
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