Healthcare Provider Details

I. General information

NPI: 1083815930
Provider Name (Legal Business Name): ALDORA HEPEL D.D.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 12/08/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1762 OLD LOUISQUISSET PIKE
LINCOLN RI
02865
US

IV. Provider business mailing address

40 OSPREY DR
EAST GREENWICH RI
02818-1338
US

V. Phone/Fax

Practice location:
  • Phone: 617-686-1220
  • Fax:
Mailing address:
  • Phone: 617-686-1220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number03237
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: