Provider Demographics
NPI:1942391297
Name:CALABRO, PHILIP J (DMD)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:J
Last Name:CALABRO
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 1:500 NEWPORT AVE
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02861-3612
Mailing Address - Country:US
Mailing Address - Phone:401-726-5600
Mailing Address - Fax:401-722-8894
Practice Address - Street 1:500 NEWPORT AVE
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02861-3612
Practice Address - Country:US
Practice Address - Phone:401-726-5600
Practice Address - Fax:401-722-8894
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN024511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice