Provider Demographics
NPI:1528153970
Name:CAVICCHIO, BARBARA MANCINI (DDS)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:MANCINI
Last Name:CAVICCHIO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1492 MINERAL SPRING AVENUE
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-3130
Mailing Address - Country:US
Mailing Address - Phone:401-353-4880
Mailing Address - Fax:401-353-1592
Practice Address - Street 1:1492 MINERAL SPRING AVENUE
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-3130
Practice Address - Country:US
Practice Address - Phone:401-353-4880
Practice Address - Fax:401-353-1592
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRI2017122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist