MEDICARE: EUGENE J. COLAO, DDS, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	3887	MD

General Provider Information

NPI Number	:	1457497117
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EUGENE J. COLAO, DDS, PA

Provider Business Mailing Address
First Line	:	5711 SARVIS AVE
Second Line	:	SUITE 600
City	:	RIVERDALE
State	:	MD
Zip	:	20737-1394
Country	:	US
Telephone Number	:	301-864-7006
Fax Number	:	301-864-7210

Provider Business Practice Location Address
First Line	:	5711 SARVIS AVE
Second Line	:	SUITE 600
City	:	RIVERDALE
State	:	MD
Zip	:	20737-1394
Country	:	US
Telephone Number	:	301-864-7006
Fax Number	:	301-864-7210

Authorized Official
Title or Position	:	PRESIDENT
Name	:	EUGENE J. COLAO
Credential	:	DDS
Telephone Number	:	301-864-7006

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	08/22/2020

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