Provider Demographics
NPI:1124158589
Name:ASARO, MATTHEW R (DMD)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:R
Last Name:ASARO
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 1:141 COUNTY ROAD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806
Mailing Address - Country:US
Mailing Address - Phone:401-245-4619
Mailing Address - Fax:
Practice Address - Street 1:141 COUNTY ROAD
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806
Practice Address - Country:US
Practice Address - Phone:401-245-4619
Practice Address - Fax:401-247-0762
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI025431223P0106X, 204E00000X, 122300000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
02543OtherDELTA
87403OtherBC
87403OtherBC