Organization
SPARTAN DENTAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIAS GEORGE KOUTROS D.D.S. (PRESIDENT)
(401) 383-7569
Entity
Organization
Contact information
Practice address
105 SOCKANOSSET CROSS RD, SUITE 316, CRANSTON, RI 02920-5560
(401) 383-7569
(401) 228-6915
Mailing address
105 SOCKANOSSET CROSS RD, SUITE 316, CRANSTON, RI 02920-5560
(401) 383-7569
(401) 228-6915
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN02860
RI
Other
Enumeration date
06/11/2013
Last updated
09/24/2013
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