NPI 1053447193 · live from the CMS NPI Registry
Peter Armand Bourdeau, DDS
Dentist, General Practice in Warwick, RI. National Provider Identifier 1053447193, active.
NPI record
| NPI | 1053447193 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, General Practice 1223G0001X |
| Practice location | 469 Centerville Rd, Suite # 107, Warwick, RI 02886 |
| Practice phone | 401-739-2345 |
| Enumerated | February 25, 2007 |
| Last updated | July 8, 2007 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, General Practice primary | 1223G0001X | DEN01704 (RI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.