Individual
NICHOLAS CHARBONNEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
24 SALT POND RD STE A2, WAKEFIELD, RI 02879-4304
(401) 783-4223
Mailing address
24 SALT POND RD STE A2, WAKEFIELD, RI 02879-4304
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DENO3628
RI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/05/2021
Last updated
04/23/2026
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