Healthcare Provider Details

I. General information

NPI: 1619881307
Provider Name (Legal Business Name): ROBERT S GILARDETTI, DMD, MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1265 RESERVOIR AVE
CRANSTON RI
02920-6060
US

IV. Provider business mailing address

1265 RESERVOIR AVE
CRANSTON RI
02920-6060
US

V. Phone/Fax

Practice location:
  • Phone: 401-464-6406
  • Fax: 401-464-6466
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number
License Number StateNULL

VIII. Authorized Official

Name: AMBER TURK
Title or Position: PRACTICE MANAGER
Credential:
Phone: 401-464-6406