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General NPI Number Information
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NPI Number | 1568611481
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Entity Type | Organization
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Legal Business Name | JOHN T. COLETTI,DDS,LTD
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Dates
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Enumeration Date | 09/16/2008
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Last Update Date | 09/16/2008
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Provider Practice Location Address
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Address Line | 469 CENTERVILLE RD SUITE 107
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City | WARWICK
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State | RI
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Zip | 02886-4354
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Country | US
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Telephone | 401-732-5800
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Fax | 401-739-2578
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Provider Business Mailing Address
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Address Line | 469 CENTERVILLE RD SUITE 107
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City | WARWICK
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State | RI
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Zip | 02886-4354
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Country | US
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Telephone | 401-732-5800
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Fax | 401-739-2578
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN TIMOTHY COLETTI
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Credential | DDS
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Telephone | 401-732-5800
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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 | 1555
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License Number State | RI
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