Organization
BEACON DENTAL HEALTH RI, PC
Active
Parent organization
BEACON DENTAL HEALTH RI, PC
Other names
Aesthetic Dentistry of Wickford
Organization subpart
Yes
Provider details
NPI number
Legal business name
BEACON DENTAL HEALTH RI, PC
Authorized official
RISHI SHUKLA (AUTHORIZED ADMINISTRATOR)
(617) 418-6940
Entity
Organization
Contact information
Practice address
1051 TEN ROD RD UNIT 5, NORTH KINGSTOWN, RI 02852-4163
(617) 418-6940
Mailing address
198 TREMONT ST STE 436, BOSTON, MA 02116-4705
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/30/2021
Last updated
04/30/2021
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