NPI 1356409247 · live from the CMS NPI Registry
Reynaldo Puertollano Baduya, D.M.D
Dentist, General Practice in Providence, RI. National Provider Identifier 1356409247, active.
NPI record
| NPI | 1356409247 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, General Practice 1223G0001X |
| Practice location | 252 Adelaide Ave, Providence, RI 02907 |
| Practice phone | 401-941-2600 |
| Enumerated | December 5, 2006 |
| Last updated | July 8, 2007 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, General Practice primary | 1223G0001X | DEN02491 (RI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.