Healthcare Provider Details

I. General information

NPI: 1942300678
Provider Name (Legal Business Name): ALBERT E. CARLOTTI JR. D.D.S.,L.L.C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2006
Last Update Date: 08/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 OAKLAWN AVE
CRANSTON RI
02920-2638
US

IV. Provider business mailing address

185 RIVER FARM DR
EAST GREENWICH RI
02818-2127
US

V. Phone/Fax

Practice location:
  • Phone: 401-490-6500
  • Fax: 401-490-2143
Mailing address:
  • Phone: 401-884-1056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDEN01339
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: