Organization
BLACKSTONE VALLEY FAMILY DENTAL ASSOCIATES
Active
Other names
ri dental
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENJAMIN RODRICK (EXECUTIVE ADMINISTRATOR)
(401) 450-2177
Entity
Organization
Contact information
Practice address
465 RESERVOIR AVE, CRANSTON, RI 02910-1728
(401) 450-2177
(401) 450-2779
Mailing address
465 RESERVOIR AVE, CRANSTON, RI 02910-1728
(401) 270-3997
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN0314
RI
Other
Enumeration date
07/22/2011
Last updated
07/22/2011
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