Provider Demographics
NPI:1770610313
Name:DR.'S WADE AND SACCOCCIO
Entity type:Organization
Organization Name:DR.'S WADE AND SACCOCCIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:G
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:401-732-5570
Mailing Address - Street 1:1600 WARWICK AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02889-1526
Mailing Address - Country:US
Mailing Address - Phone:401-732-5570
Mailing Address - Fax:401-732-8308
Practice Address - Street 1:1600 WARWICK AVE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02889-1526
Practice Address - Country:US
Practice Address - Phone:401-732-5570
Practice Address - Fax:401-732-8308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty