| Great Lakes Dental, Inc | |
|
26 Hartford Pike North Scituate RI 02857-1865 | |
| (401) 934-2666 | |
| Not Available |
| Full Name | Great Lakes Dental, Inc |
|---|---|
| Speciality | Dentist |
| Location | 26 Hartford Pike, North Scituate, Rhode Island |
| Authorized Official Name and Position | Kenpan Hu (PRESIDENT) |
| Authorized Official Contact | 6173197110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Lakes Dental, Inc 26 Hartford Pike North Scituate RI 02857-1865 Ph: (401) 934-2666 | Great Lakes Dental, Inc 26 Hartford Pike North Scituate RI 02857-1865 Ph: (401) 934-2666 |
| NPI Number | 1285977173 |
|---|---|
| Provider Enumeration Date | 03/29/2013 |
| Last Update Date | 03/29/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285977173 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DEN03175 (Rhode Island) | Primary |
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