Organization
JEFFERSON DENTAL ASSOCIATES, L.T.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELVIN ERIC HANZEL D.M.D. (PRESIDENT)
(401) 739-2350
Entity
Organization
Contact information
Practice address
222 JEFFERSON BLVD, WARWICK, RI 02888-3855
(401) 739-2350
Mailing address
222 JEFFERSON BLVD, WARWICK, RI 02888-3855
(401) 739-2350
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
2610
RI
1223G0001X
General Practice Dentistry
Primary
1846
RI
1223G0001X
General Practice Dentistry
2654
RI
1223P0300X
Periodontics
1681
RI
Other
Enumeration date
04/22/2008
Last updated
04/22/2008
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