Healthcare Provider Details

I. General information

NPI: 1902234610
Provider Name (Legal Business Name): RAFFI MERJIK DMD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2013
Last Update Date: 10/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 HARTFORD PIKE
N SCITUATE RI
02857-1865
US

IV. Provider business mailing address

26 HARTFORD PIKE
N SCITUATE RI
02857-1865
US

V. Phone/Fax

Practice location:
  • Phone: 401-934-2666
  • Fax:
Mailing address:
  • Phone: 401-934-2666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN03196
License Number StateRI

VIII. Authorized Official

Name: DR. RAFFI MERJIK
Title or Position: OWNER
Credential: DMD
Phone: 401-934-2666