Dzialo, Walter Matthew

Dzialo, Walter Matthew is an sole proprietor health care provider with primary practice located at 526 Newport Ave , Pawtucket RI 02861-3612. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Dzialo, Walter Matthew can be contacted via phone (401) 724-2570.

Contact Information

Primary practice address
526 Newport Ave Pawtucket RI 02861-3612
Phone: (401) 724-2570
Fax: (401) 724-0199
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DEN01869 Rhode Island
Dental Providers / General Practice 1223G0001X 14966 Massachusetts

Profile Details

NPI number 1487752432
LBN Legal business name Dzialo, Walter Matthew
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 20th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487752432 NPPES
Rhode Island MEDICAID WD00135

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