Healthcare Provider Details

I. General information

NPI: 1861356743
Provider Name (Legal Business Name): A T DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 TOLL GATE RD STE 104
WARWICK RI
02886-4487
US

IV. Provider business mailing address

200 TOLL GATE RD STE 102
WARWICK RI
02886-4440
US

V. Phone/Fax

Practice location:
  • Phone: 401-737-9363
  • Fax:
Mailing address:
  • Phone: 719-966-9147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: AHMED TAREK ABDELAAL
Title or Position: OWNER
Credential:
Phone: 719-966-9147