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Contact Information

31 ELMGROVE DENTAL LLC
31 ELMGROVE AVE
PROVIDENCE, RI02906-4103
 Phone: 401-421-9350
 Fax: 401-421-6450
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for 31 ELMGROVE DENTAL LLC · (Female)

NPI # 1225787708
Status Active
Credentials
Entity Individual
Enumeration date 03/22/2022
Last updated 03/22/2022 - About 4 years ago
Sole proprietor 1 Not specified
Identifiers
  • RI Medicaid MP01974
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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