Individual
DR. WALTER MATTHEW DZIALO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
526 NEWPORT AVE, PAWTUCKET, RI 02861-3612
(401) 724-2570
(401) 724-0199
Mailing address
37 TASHMOO WAY, PAWTUCKET, RI 02861-3712
(401) 725-4465
(401) 725-0158
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
14966
MA
1223G0001X
General Practice Dentistry
Primary
DEN01869
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
WD00135
—
RI
Enumeration date
09/20/2006
Last updated
07/08/2007
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