Provider Demographics
NPI:1013131895
Name:DAMBROSIO, HUGO P JR (DDS MSCD DSC DSCD)
Entity Type:Individual
Prefix:DR
First Name:HUGO
Middle Name:P
Last Name:DAMBROSIO
Suffix:JR
Gender:M
Credentials:DDS MSCD DSC DSCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 BRAMBLEBUSH PARK
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540
Mailing Address - Country:US
Mailing Address - Phone:508-548-7644
Mailing Address - Fax:508-548-7003
Practice Address - Street 1:8 BRAMBLEBUSH PARK
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540
Practice Address - Country:US
Practice Address - Phone:508-548-7644
Practice Address - Fax:508-548-7003
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA126561223D0001X, 1223P0221X, 1223P0300X, 1223S0112X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223D0001XDental ProvidersDentistDental Public Health
Not Answered1223P0221XDental ProvidersDentistPediatric Dentistry
Not Answered1223P0300XDental ProvidersDentistPeriodontics
Not Answered1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics