Provider Demographics
NPI:1629236559
Name:STRUZZIERO, RICHARD F (DMD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:F
Last Name:STRUZZIERO
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 1:575 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-5614
Mailing Address - Country:US
Mailing Address - Phone:784-848-2444
Mailing Address - Fax:781-356-0800
Practice Address - Street 1:575 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-5614
Practice Address - Country:US
Practice Address - Phone:784-848-2444
Practice Address - Fax:781-356-0800
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA115281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice