Organization
BAYSIDE DENTAL INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL M KOTUBY JR. D.M.D. (DENTIST)
(401) 253-3781
Entity
Organization
Contact information
Practice address
15 GOODING AVE, SUITE 1, BRISTOL, RI 02809-2600
(401) 253-3781
(401) 253-9324
Mailing address
15 GOODING AVE, SUITE 1, BRISTOL, RI 02809-2600
(401) 253-3781
(401) 253-9324
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN01874
RI
Other
Enumeration date
04/09/2007
Last updated
08/22/2020
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