Organization
JACOB WERBA DDS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB DAVID WERBA DDS (OWNER)
(401) 751-9050
Entity
Organization
Contact information
Practice address
655 BROAD ST, PROVIDENCE, RI 02907-1444
(401) 751-9050
(401) 861-0873
Mailing address
655 BROAD ST, PROVIDENCE, RI 02907-1444
(401) 751-9050
(401) 861-0873
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN01863
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
JW57856
—
RI
Enumeration date
05/04/2007
Last updated
08/22/2020
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