Provider Demographics
NPI:1083798706
Name:DICARLO, RONALD ANTHONY (DMD)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:ANTHONY
Last Name:DICARLO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 E CARSON STREET
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203
Mailing Address - Country:US
Mailing Address - Phone:412-431-6631
Mailing Address - Fax:412-431-6297
Practice Address - Street 1:1408 E CARSON STREET
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203
Practice Address - Country:US
Practice Address - Phone:412-431-6631
Practice Address - Fax:412-431-6297
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS018546L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist