Organization
MAXILLOFACIAL SURGEONS, LTD.
Active
Other names
MSL Facial & Oral Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY R PETITO DDS, MD (PRESIDENT)
(401) 739-5500
Entity
Organization
Contact information
Practice address
243 JEFFERSON BLVD, WARWICK, RI 02888-3818
(401) 739-5500
(401) 738-1550
Mailing address
243 JEFFERSON BLVD, WARWICK, RI 02888-3818
(401) 739-5500
(401) 738-1550
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9008578
—
RI
Enumeration date
02/27/2006
Last updated
08/22/2020
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