Individual
DR. PETER PAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
151 WATERMAN ST, PROVIDENCE, RI 02906-2118
(401) 273-6161
Mailing address
151 WATERMAN ST, PROVIDENCE, RI 02906-2118
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
13148
MA
1223P0300X
Periodontics
Primary
DEN01816
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8404-6
BLUE CROSS DENTAL
RI
Enumeration date
01/20/2007
Last updated
07/08/2007
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