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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

NPI # 1225787708
LBN Legal business name 31 ELMGROVE DENTAL LLC
Authorized official JESSICA POLAK - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/22/2022
Last updated 03/22/2022 - About 4 years ago
Identifiers
RI Medicaid MP01974
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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