Provider Demographics
NPI:1275552671
Name:RILEY, DENNIS MARTIN (RPH)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:MARTIN
Last Name:RILEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 LYDIA AVE
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-6604
Mailing Address - Country:US
Mailing Address - Phone:401-766-8399
Mailing Address - Fax:
Practice Address - Street 1:595 LYDIA AVE
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-6604
Practice Address - Country:US
Practice Address - Phone:401-766-8399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI2233183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist