Individual
DR. MICHAEL BRIAN FORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2000 DIAMOND HILL RD, WOONSOCKET, RI 02895-1554
(401) 766-8600
(401) 766-8601
Mailing address
2000 DIAMOND HILL RD, WOONSOCKET, RI 02895-1554
(401) 766-8600
(401) 766-8601
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN2031
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MF02311
—
RI
Enumeration date
09/27/2006
Last updated
03/18/2023
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