Provider Demographics
NPI:1518140805
Name:COLAO, GENE JOSEPH (DDS)
Entity Type:Individual
Prefix:
First Name:GENE
Middle Name:JOSEPH
Last Name:COLAO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:EUGENE
Other - Middle Name:JOSEPH
Other - Last Name:COLAO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
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:
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:
Is Sole Proprietor?:No
Enumeration Date:2007-12-10
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD38871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice