Healthcare Provider Details

I. General information

NPI: 1871677583
Provider Name (Legal Business Name): MARK S. BICHAJIAN, DMD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 03/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 WARWICK AVE
WARWICK RI
02888-2670
US

IV. Provider business mailing address

708 WARWICK AVE
WARWICK RI
02888-2670
US

V. Phone/Fax

Practice location:
  • Phone: 401-785-2111
  • Fax: 401-941-1547
Mailing address:
  • Phone: 401-785-2111
  • Fax: 401-941-1547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. JOANNE SCHIAVULLI
Title or Position: OFFICE MANAGER
Credential:
Phone: 401-785-2111