Individual
DR. ROBERT EDWARD NIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
40 TOLL GATE RD, WARWICK, RI 02886-4444
(401) 737-9363
Mailing address
40 TOLL GATE RD, WARWICK, RI 02886-4444
(401) 737-9363
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
RI 27-89
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8002-2
BLUE CROSS DENTAL
RI
01
—
MEDICAL ASSISTANCE
RN58122
RI
01
—
RI 27-89
DELTA DENTAL OF RI
RI
01
—
UNITED HEALTH
0262421
—
Enumeration date
03/09/2007
Last updated
07/08/2007
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