Healthcare Provider Details

I. General information

NPI: 1457271314
Provider Name (Legal Business Name): MRT DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 PONTIAC AVE STE 201
CRANSTON RI
02920-4455
US

IV. Provider business mailing address

903 PROVIDENCE PL APT 101
PROVIDENCE RI
02903-7001
US

V. Phone/Fax

Practice location:
  • Phone: 616-490-1754
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. RUPINDER SANDHU
Title or Position: OWNER
Credential: DMD
Phone: 616-490-1754