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General NPI Number Information
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NPI Number | 1659728145
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Entity Type | Individual
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Provider Name | RILEY GIONFRIDDO DMD
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Gender | Female
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Dates
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Enumeration Date | 05/16/2016
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Last Update Date | 03/22/2018
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Provider Practice Location Address
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Address Line | 60 ADAMS ST
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City | BRAINTREE
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State | MA
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Zip | 02184-1907
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Country | US
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Telephone | 787-843-0660
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Fax |
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Provider Business Mailing Address
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Address Line | 24 FARQUHAR ST # 1
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City | BOSTON
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State | MA
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Zip | 02131-1508
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Country | US
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Telephone | 860-942-3868
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 157779482
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License Number State | CT
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