Healthcare Provider Details

I. General information

NPI: 1821011107
Provider Name (Legal Business Name): MARY FRANCES DZURINKO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 MAIN ST
HOPE VALLEY RI
02832-1920
US

IV. Provider business mailing address

823 MAIN ST
HOPE VALLEY RI
02832-1920
US

V. Phone/Fax

Practice location:
  • Phone: 401-539-2461
  • Fax: 401-539-2663
Mailing address:
  • Phone: 401-539-2461
  • Fax: 401-539-2663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN02679
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: