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General NPI Number Information
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NPI Number | 1982726139
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Entity Type | Organization
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Legal Business Name | H. M. VINCENT, D.M.D., LLC
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 07/21/2014
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Provider Practice Location Address
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Address Line | 719 ARMISTICE BLVD
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City | PAWTUCKET
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State | RI
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Zip | 02861-2746
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Country | US
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Telephone | 401-728-1706
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Fax |
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Provider Business Mailing Address
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Address Line | 719 ARMISTICE BLVD
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City | PAWTUCKET
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State | RI
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Zip | 02861-2746
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Country | US
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Telephone | 401-728-1706
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | HOWARD MARCUS VINCENT
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Credential | DMD
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Telephone | 401-728-1706
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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 | DEN 02966
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License Number State | RI
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