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General NPI Number Information
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NPI Number | 1134160559
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Entity Type | Organization
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Legal Business Name | AQUIDNECK AESTHETIC DENTISTRY INC.
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 460 E MAIN RD
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City | MIDDLETOWN
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State | RI
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Zip | 02842-7227
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Country | US
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Telephone | 401-849-3008
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Fax | 401-849-3083
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Provider Business Mailing Address
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Address Line | 460 E MAIN RD
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City | MIDDLETOWN
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State | RI
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Zip | 02842-7227
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Country | US
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Telephone | 401-849-3008
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Fax | 401-849-3083
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD WINTHROP FRANK
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Credential | D.M.D.
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Telephone | 401-849-3008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 02414
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License Number State | RI
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