Organization
WOONSOCKET DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL BRIAN FORMAN D.M.D. (PRESIDENT)
(401) 766-8600
Entity
Organization
Contact information
Practice address
2000 DIAMOND HILL RD, WOONSOCKET, RI 02895-1554
(401) 766-8600
(401) 766-8601
Mailing address
2000 DIAMOND HILL RD, WOONSOCKET, RI 02895-1554
(401) 766-8600
(401) 766-8601
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN2031
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
WD02303
—
RI
Enumeration date
10/02/2006
Last updated
08/22/2020
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