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NPI Code Detail

MEDICARE: DR. LES R PRASAD D.D.S

MEDICARE:  DR. LES R PRASAD  D.D.S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist01827RI

General Provider Information

NPI Number : 1831219443
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LES R PRASAD D.D.S
Provider Business Mailing Address
First Line : 8 MAPLEWOOD DR
Second Line :
City : LINCOLN
State : RI
Zip : 02865-4526
Country : US
Telephone Number : 401-728-8924
Fax Number : 401-228-7188
Provider Business Practice Location Address
First Line : 989 RESERVOIR AVE
Second Line :
City : CRANSTON
State : RI
Zip : 02910-5138
Country : US
Telephone Number : 401-944-7556
Fax Number : 401-228-7188
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2007
Last Update Date : 07/08/2007

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Directions to “ DR. LES R PRASAD D.D.S” Practice Location

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