Provider Demographics
NPI:1295382398
Name:PLUM DENTAL RI, LLC
Entity Type:Organization
Organization Name:PLUM DENTAL RI, LLC
Other - Org Name:ANGEL STREET DENTAL LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPALBO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:401-741-7395
Mailing Address - Street 1:29 UPDIKE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-5728
Mailing Address - Country:US
Mailing Address - Phone:860-944-4149
Mailing Address - Fax:
Practice Address - Street 1:880 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-3113
Practice Address - Country:US
Practice Address - Phone:401-884-5242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PLUM DENTAL RI, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-22
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental