31 Elmgrove Dental Llc

LBN: 31 Elmgrove Dental Llc
31 Elmgrove Dental Llc is an health care organization with primary practice located at 31 Elmgrove Ave , Providence RI 02906-4103. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. 31 Elmgrove Dental Llc can be contacted via phone (401) 421-9350, or through Polak, Jessica A via phone (401) 421-9350.

Contact Information

Primary practice address
31 Elmgrove Ave Providence RI 02906-4103
Phone: (401) 421-9350
Fax: (401) 421-6450
Website:
Map and Directions
Authorized official contact:
Name: Polak, Jessica A Certified Dental Assistant (CDA)
Phone: (401) 421-9350

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X

Profile Details

NPI number 1225787708
LBN Legal business name 31 Elmgrove Dental Llc
DBA Doing business as
Authorized official Polak, Jessica A Certified Dental Assistant (CDA)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 22nd, 2022
Last updated Mar 22nd, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225787708 NPPES
Rhode Island MEDICAID MP01974

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