| Dutchmen Dental Llc | |
|
1359 Main Rd Tiverton RI 02878-4426 | |
| (401) 624-9177 | |
| (401) 624-9233 |
| Full Name | Dutchmen Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1359 Main Rd, Tiverton, Rhode Island |
| Authorized Official Name and Position | Jon Paul Van Regenmorter (OWNER) |
| Authorized Official Contact | 4016249177 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dutchmen Dental Llc 1359 Main Rd Tiverton RI 02878-4426 Ph: (401) 624-9177 | Dutchmen Dental Llc 1359 Main Rd Tiverton RI 02878-4426 Ph: (401) 624-9177 |
| NPI Number | 1912172016 |
|---|---|
| Provider Enumeration Date | 04/29/2008 |
| Last Update Date | 04/29/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912172016 | NPI | - | NPPES |
| 8094-5 | Other | RI | BLUE CROSS BLUE SHIELD OF RI |
| X12325 | Other | MA | BLUE CROSS BLUE SHIELD OF MA |
| 0281077 | Medicaid | MA | |
| 9197544 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DEN02748 (Rhode Island) | Primary |
Tiverton Dental Associates Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1061 Fish Rd, Tiverton, RI 02878 Phone: 401-624-2901 Fax: 401-624-6446 | |
Stone Bridge Dental Group Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1750 Main Rd, Tiverton, RI 02878 Phone: 401-624-2375 | |
Jon-paul Van Regenmorter Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1359 Main Rd, Tiverton, RI 02878 Phone: 401-624-9177 Fax: 401-624-9233 |