Individual
KEENAN SANDOUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1009 MAIN AVE, WARWICK, RI 02886-1972
(401) 737-1929
(401) 737-2140
Mailing address
1009 MAIN AVE, WARWICK, RI 02886-1972
(401) 737-1929
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN03550
RI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/15/2020
Last updated
03/12/2026
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