Provider Demographics
NPI:1568611481
Name:JOHN T. COLETTI,DDS,LTD
Entity Type:Organization
Organization Name:JOHN T. COLETTI,DDS,LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:TIMOTHY
Authorized Official - Last Name:COLETTI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:401-732-5800
Mailing Address - Street 1:469 CENTERVILLE RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-4354
Mailing Address - Country:US
Mailing Address - Phone:401-732-5800
Mailing Address - Fax:401-739-2578
Practice Address - Street 1:469 CENTERVILLE RD
Practice Address - Street 2:SUITE 107
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4354
Practice Address - Country:US
Practice Address - Phone:401-732-5800
Practice Address - Fax:401-739-2578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI15551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty