Healthcare Provider Details

I. General information

NPI: 1730353475
Provider Name (Legal Business Name): ROBERTWALMEIDADDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2008
Last Update Date: 04/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 BROOK ST SUITE #8
SEEKONK MA
02771-4500
US

IV. Provider business mailing address

21 BROOK ST SUITE #8
SEEKONK MA
02771-4500
US

V. Phone/Fax

Practice location:
  • Phone: 508-399-7073
  • Fax:
Mailing address:
  • Phone: 508-399-7073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number14374
License Number StateMA

VIII. Authorized Official

Name: DR. ROBERT W ALMEIDA
Title or Position: PRESIDENT
Credential: DDS
Phone: 508-399-7073