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General NPI Number Information
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NPI Number | 1780739581
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Entity Type | Individual
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Provider Name | PHILIPPE MORISSEAU D.M.D
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Gender | Male
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1051 TEN ROD RD UNIT 5
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City | NORTH KINGSTOWN
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State | RI
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Zip | 02852-4163
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Country | US
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Telephone | 401-295-5511
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Fax |
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Provider Business Mailing Address
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Address Line | 360 POTTER RD
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City | NORTH KINGSTOWN
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State | RI
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Zip | 02852-1646
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Country | US
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Telephone | 401-884-1243
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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 | 2270
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License Number State | RI
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