Provider Demographics
NPI:1912048067
Name:PALLESCHI, MARK M (DDS)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:M
Last Name:PALLESCHI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1351 S COUNTY TRL
Mailing Address - Street 2:BUILDING 2, SUITE 205
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-5105
Mailing Address - Country:US
Mailing Address - Phone:401-885-6460
Mailing Address - Fax:401-885-3933
Practice Address - Street 1:1351 S COUNTY TRL
Practice Address - Street 2:BUILDING 2, SUITE 205
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-5105
Practice Address - Country:US
Practice Address - Phone:401-885-6460
Practice Address - Fax:401-885-3933
Is Sole Proprietor?:No
Enumeration Date:2007-02-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RI21231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice