| Name: | PROVIDENCE DENTAL GROUP, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 19 May 2017 (8 years ago) |
| Date of Dissolution: | 14 Feb 2022 (3 years ago) |
| Date of Status Change: | 14 Feb 2022 (3 years ago) |
| Identification Number: | 001673922 |
| Principal Address: | 500 CHAPMAN STREET SUITE 201, CANTON, MA, 02021, USA |
| Purpose: | DENTAL PRACTICE. |
NAICS
621210 Offices of DentistsThis industry comprises establishments of health practitioners having the degree of D.M.D. (Doctor of Dental Medicine), D.D.S. (Doctor of Dental Surgery), or D.D.Sc. (Doctor of Dental Science) primarily engaged in the independent practice of general or specialized dentistry or dental surgery. These practitioners operate private or group practices in their own offices (e.g., centers, clinics) or in the facilities of others, such as hospitals or HMO medical centers. They can provide either comprehensive preventive, cosmetic, or emergency care, or specialize in a single field of dentistry. Learn more at the U.S. Census Bureau
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588140818 | 2018-07-19 | 2018-07-19 | 500 CHAPMAN ST UNIT 201, CANTON, MA, 020212040, US | 200 WATERMAN ST, PROVIDENCE, RI, 029064039, US | |||||||||||||||
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| Phone | +1 617-383-6687 |
| Phone | +1 401-421-2022 |
Authorized person
| Name | RICHARD TODD MILLER |
| Role | PRESIDENT |
| Phone | 7815620457 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 450 VETERANS MEMORIAL PARKWAY SUITE 7A, EAST PROVIDENCE, RI, 02914, USA |
| Name | Role | Address |
|---|---|---|
| RICHARD T. MILLER D.M.D. | MANAGER | 500 CHAPMAN STREET CANTON, MA 02021 USA |
| Number | Name | File Date |
|---|---|---|
| 202210339770 | Revocation Certificate For Failure to File the Annual Report for the Year | 2022-02-14 |
| 202105948980 | Revocation Notice For Failure to File An Annual Report | 2021-12-03 |
| 202036185430 | Annual Report | 2020-03-10 |
| 201924270450 | Statement of Change of Registered/Resident Agent | 2019-10-15 |
| 201988510860 | Annual Report | 2019-03-13 |
| 201985450060 | Annual Report | 2019-01-30 |
| 201743338120 | Articles of Organization | 2017-05-19 |
Date of last update: 26 Oct 2024
Sources: Rhode Island Department of State
