Organization Name: | SOUTH COUNTY PEDIATRIC DENTISTRY, LLC |
NPI Number: | 1336548130 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MATTHEW WESTCOTT DOWNEY (OWNER/PEDIATRIC DENTIST) |
Mailing Address: | 6 Lambert Street Narragansett |
State: | RI US |
Postal Code: | 028823399 |
Phone Number: | 4017897200 |
Fax Number: | 4017897205 |
NPI Enumeration Date: | 08/18/2014 |
NPI Last Update Date: | 08/26/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | DEN03116 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | RI |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |