MEDICARE: RONALD J. DOWGIALLO, D.M.D.

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	1223G0001X	General Practice Dentistry	10378	MA

General Provider Information

NPI Number	:	1538179239
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RONALD J. DOWGIALLO, D.M.D.

Provider Business Mailing Address
First Line	:	376 ROUTE 28
Second Line	:
City	:	HARWICH PORT
State	:	MA
Zip	:	02646-1626
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	376 ROUTE 28
Second Line	:
City	:	HARWICH PORT
State	:	MA
Zip	:	02646-1626
Country	:	US
Telephone Number	:	508-432-3118
Fax Number	:	508-432-7963

Authorized Official
Title or Position	:	SECRETARY
Name	:	SARA HOMER
Credential	:
Telephone Number	:	508-432-3118

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	08/22/2020

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