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General NPI Number Information
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NPI Number | 1437394087
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER A. PEDORELLA DMD, PC
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Dates
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Enumeration Date | 12/11/2008
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Last Update Date | 12/22/2008
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Provider Practice Location Address
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Address Line | 5586 POST RD
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City | EAST GREENWICH
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State | RI
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Zip | 02818-3454
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Country | US
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Telephone | 401-884-3110
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Fax | 401-885-7258
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Provider Business Mailing Address
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Address Line | 5586 POST RD UNIT 102
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City | EAST GREENWICH
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State | RI
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Zip | 02818-3454
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Country | US
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Telephone | 401-884-3110
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Fax | 401-885-7258
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Authorized Official
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Title or Position | DENTIST
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Name | CHRISTOPHER A PEDORELLA
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Credential | DMD
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Telephone | 401-884-3119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2645
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License Number State | RI
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