Individual
DR. ANTHONY ROCCO PETITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
400 MASSASOIT AVE, SUITE 103, EAST PROVIDENCE, RI 02914-2012
(401) 919-5560
(401) 919-5740
Mailing address
400 MASSASOIT AVE, SUITE 103, EAST PROVIDENCE, RI 02914-2012
(401) 919-5560
(401) 919-5740
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
02552
RI
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
MD09730
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7006548
—
RI
Enumeration date
05/04/2006
Last updated
03/01/2012
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