Provider Demographics
NPI:1598830788
Name:PICARD, JOEL FREDERICK I (DDS)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:FREDERICK
Last Name:PICARD
Suffix:I
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 HAMLET AVE
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-4423
Mailing Address - Country:US
Mailing Address - Phone:401-769-0047
Mailing Address - Fax:401-769-2555
Practice Address - Street 1:52 HAMLET AVE
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-4423
Practice Address - Country:US
Practice Address - Phone:401-769-0047
Practice Address - Fax:401-769-2555
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI023121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI02312OtherDELTA DENTAL OF RI
RI8801-7OtherBLUE CROSS DENTAL OF RI
RIJP00095OtherRI MEDICAL ASSISTANCE