Healthcare Provider Details

I. General information

NPI: 1669458071
Provider Name (Legal Business Name): ALBERT R ARCAND DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 10/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1079 MAIN STREET SUITE B
WEST WARWICK RI
02893
US

IV. Provider business mailing address

1079 MAIN STREET SUITE B
WEST WARWICK RI
02893
US

V. Phone/Fax

Practice location:
  • Phone: 401-826-2833
  • Fax: 401-826-2833
Mailing address:
  • Phone: 401-826-2833
  • Fax: 401-826-2833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number02490
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: