Provider Demographics
NPI:1093099418
Name:RONALD J. KOLODZIEJ, DMD PC
Entity Type:Organization
Organization Name:RONALD J. KOLODZIEJ, DMD PC
Other - Org Name:FRAMINGHAM COSMETIC DENTIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:KOLODZIEJ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-620-1170
Mailing Address - Street 1:223 WALNUT ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-7500
Mailing Address - Country:US
Mailing Address - Phone:508-620-1170
Mailing Address - Fax:508-370-0109
Practice Address - Street 1:223 WALNUT ST
Practice Address - Street 2:SUITE 3
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-7500
Practice Address - Country:US
Practice Address - Phone:508-620-1170
Practice Address - Fax:508-370-0109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA133801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty