Doctor Name: | ROBERT S GILARDETTI |
NPI Number: | 1013975952 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 152305 |
Business Practice Address: | 691 Kingstown Rd Wakefield, RI - 028793015 |
Business Phone Number: | 4017899758 |
Business Fax Number: | 4017899763 |
Mailing Address: | 691 Kingstown Rd, WAKEFIELD |
State: | RI |
Postal Code: | 028793015 |
Phone Number: | 4017899758 |
Fax Number: | |
NPI Enumeration Date: | 05/02/2006 |
NPI Last Update Date: | 08/30/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204E00000X |
License Number: | 152305 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Oral & Maxillofacial Surgery |
Taxonomy Specialization: | |
Taxonomy Definition: |