Kerri-Rae Agin, D.M.D

Individual provider Active NPI General Practice Dentistry · Woonsocket, RI

NPI 1346355815 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1346355815
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2563 (RI)
Practice address
1413 Diamond Hill Rd
Woonsocket, RI 02895-1510
Phone
(401) 769-0500
Fax
(401) 769-0502
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2563RIMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2563 RI Yes

Addresses

Primary practice location

1413 Diamond Hill Rd
Woonsocket, RI 02895-1510

Mailing address

23 Oak Grove Blvd
North Providence, RI 02911-2608
Phone (401) 354-8336

Other providers in Woonsocket, RI

All providers in Woonsocket, RI · General Practice Dentistry in Rhode Island

Sources for this page

Verify at the official NPI Registry.