Provider Demographics
NPI:1457497117
Name:EUGENE J. COLAO, DDS, PA
Entity Type:Organization
Organization Name:EUGENE J. COLAO, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:J
Authorized Official - Last Name:COLAO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-864-7006
Mailing Address - Street 1:5711 SARVIS AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1394
Mailing Address - Country:US
Mailing Address - Phone:301-864-7006
Mailing Address - Fax:301-864-7210
Practice Address - Street 1:5711 SARVIS AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1394
Practice Address - Country:US
Practice Address - Phone:301-864-7006
Practice Address - Fax:301-864-7210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3887122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty