Healthcare Provider Details

I. General information

NPI: 1417707506
Provider Name (Legal Business Name): EMMA PAOLELLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2024
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 BROAD ST
CENTRAL FALLS RI
02863-1507
US

IV. Provider business mailing address

635 ALBANY ST
BOSTON MA
02118-3550
US

V. Phone/Fax

Practice location:
  • Phone: 401-722-0081
  • Fax:
Mailing address:
  • Phone: 617-358-8300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN03798
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: