Provider Demographics
NPI:1225241953
Name:STEPHEN J PUERINI DMD AND STEVEN J SACCOCCIO DMD PC
Entity Type:Organization
Organization Name:STEPHEN J PUERINI DMD AND STEVEN J SACCOCCIO DMD PC
Other - Org Name:DRS. PUERINI & SACCOCCIO DMD
Other - Org Type:Other Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PUERINI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:401-944-8100
Mailing Address - Street 1:115 BUDLONG ROAD
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920
Mailing Address - Country:US
Mailing Address - Phone:401-944-8100
Mailing Address - Fax:401-946-1060
Practice Address - Street 1:115 BUDLONG ROAD
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920
Practice Address - Country:US
Practice Address - Phone:401-944-8100
Practice Address - Fax:401-946-1060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1223G0001X
RI1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty