Healthcare Provider Details

I. General information

NPI: 1588732382
Provider Name (Legal Business Name): DRS KENNETH & ROBIN RAWLINSON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2861 PAWTUCKET AVE
RIVERSIDE RI
02915
US

IV. Provider business mailing address

2861 PAWTUCKET AVE
RIVERSIDE RI
02915
US

V. Phone/Fax

Practice location:
  • Phone: 401-434-1334
  • Fax: 401-434-7939
Mailing address:
  • Phone: 401-434-1334
  • Fax: 401-434-7939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. KENNETH J RAWLINSON
Title or Position: DENTIST
Credential: DDS
Phone: 401-434-1334