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General NPI Number Information
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NPI Number | 1386000552
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Entity Type | Individual
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Provider Name | ILIANA SAAVEDRA D.D.S
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Gender | Female
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Dates
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Enumeration Date | 01/04/2016
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Last Update Date | 01/29/2024
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Provider Practice Location Address
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Address Line | 888 BROADWAY
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City | EAST PROVIDENCE
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State | RI
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Zip | 02914-3742
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Country | US
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Telephone | 401-228-3999
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Fax |
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Provider Business Mailing Address
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Address Line | 158 ARNOLD AVE
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City | CRANSTON
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State | RI
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Zip | 02905-3816
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Country | US
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Telephone | 361-563-0168
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DEN03308
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License Number State | RI
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