Healthcare Provider Details

I. General information

NPI: 1912116575
Provider Name (Legal Business Name): ROBERT W. MIER, DDS, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 QUAKER LN
WARWICK RI
02886-0111
US

IV. Provider business mailing address

80 QUAKER LN
WARWICK RI
02886-0111
US

V. Phone/Fax

Practice location:
  • Phone: 401-821-6500
  • Fax: 401-823-8270
Mailing address:
  • Phone: 401-821-6500
  • Fax: 401-823-8270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDNT2122
License Number StateRI

VIII. Authorized Official

Name: ROBERT W. MIER
Title or Position: PRESIDENT
Credential: DDS
Phone: 401-821-6500