Provider Demographics
NPI:1316665979
Name:FAMILY SMILES DENTAL CARE
Entity type:Organization
Organization Name:FAMILY SMILES DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SRIDEVI
Authorized Official - Middle Name:
Authorized Official - Last Name:DUGGIRALA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:401-724-2570
Mailing Address - Street 1:526 NEWPORT AVE
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02861-3612
Mailing Address - Country:US
Mailing Address - Phone:401-724-2570
Mailing Address - Fax:401-724-0199
Practice Address - Street 1:526 NEWPORT AVE
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02861-3612
Practice Address - Country:US
Practice Address - Phone:401-724-2570
Practice Address - Fax:401-724-0199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental