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General NPI Number Information
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NPI Number | 1497072763
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Entity Type | Organization
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Legal Business Name | DENTAL ASSOCIATES OF RI
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Dates
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Enumeration Date | 04/27/2010
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Last Update Date | 04/26/2022
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Provider Practice Location Address
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Address Line | 1414 ATWOOD AVE, STE 350
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City | JOHNSTON
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State | RI
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Zip | 02919
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Country | US
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Telephone | 401-331-7665
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Fax | 401-331-7666
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Provider Business Mailing Address
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Address Line | 1414 ATWOOD AVE, STE 350
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City | JOHNSTON
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State | RI
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Zip | 02919
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Country | US
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Telephone | 401-331-7665
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Fax | 401-331-7666
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. RUPESH UDESHI
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Credential | DMD
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Telephone | 401-331-7665
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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 | DEN03011
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License Number State | MA
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