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Individual

ROBERT TRENT DAFFNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
830 CHALKSTONE AVE, VAMC PROVIDENCE - DENTAL SERVICE 650, PROVIDENCE, RI 02908-4734
(401) 457-3018
Mailing address
830 CHALKSTONE AVE, VAMC PROVIDENCE - DENTAL SERVICE 650, PROVIDENCE, RI 02908-4734
(401) 457-3018

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
49085
CA

Other

Enumeration date
10/03/2006
Last updated
07/08/2007
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