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Individual

DANIEL BOATENG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
21 PEACE ST, PROVIDENCE, RI 02907-1510
(401) 456-4461
Mailing address
1013 BURNET AVE, UNION, NJ 07083-5610

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS044467
PA
390200000X
Student in an Organized Health Care Education/Training Program
RI

Other

Enumeration date
04/01/2022
Last updated
06/21/2024
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