Provider Demographics
NPI:1184118127
Name:KNARR, ERICA ANN (DMD)
Entity type:Individual
Prefix:DR
First Name:ERICA
Middle Name:ANN
Last Name:KNARR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MS
Other - First Name:ERICA
Other - Middle Name:ANN
Other - Last Name:BOFFI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:375 ALLENS AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-5010
Mailing Address - Country:US
Mailing Address - Phone:401-444-0400
Mailing Address - Fax:401-444-0468
Practice Address - Street 1:335 PRAIRIE AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905
Practice Address - Country:US
Practice Address - Phone:401-444-0430
Practice Address - Fax:401-444-0489
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-21
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME4652122300000X
RIDEN03449122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist