Organization
CGHE DENTAL LLC
Active
Other names
ATWILL CONROY DENTAL ASSOCIATES
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTOFER HAGGARTY DMD (MEMBER)
(401) 351-3090
Entity
Organization
Contact information
Practice address
1196 SMITH ST, PROVIDENCE, RI 02908-2036
(401) 351-3090
(401) 331-1315
Mailing address
1196 SMITH ST, PROVIDENCE, RI 02908-2036
(401) 351-3090
(401) 331-1315
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2350
RI
1223G0001X
General Practice Dentistry
2663
RI
1223G0001X
General Practice Dentistry
Primary
2744
RI
1223G0001X
General Practice Dentistry
2837
RI
Other
Enumeration date
03/21/2011
Last updated
03/21/2011
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