Organization
PORTSMOUTH DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHAN WAYNE TILMAN DDS (OWNER/DENTIST)
(401) 683-9724
Entity
Organization
Contact information
Practice address
2765 E MAIN RD, PORTSMOUTH, RI 02871-2605
(401) 683-9724
Mailing address
136 BROADWAY, NEWPORT, RI 02840-2748
(401) 683-9724
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN02928
RI
Other
Enumeration date
06/18/2015
Last updated
07/28/2015
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