Provider Demographics
NPI:1194070763
Name:ZUPPARDI, RICHARD A (DDS)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:ZUPPARDI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:536 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:EAST WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02189-1362
Mailing Address - Country:US
Mailing Address - Phone:781-331-2442
Mailing Address - Fax:781-337-8981
Practice Address - Street 1:536 BROAD ST
Practice Address - Street 2:
Practice Address - City:EAST WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-1362
Practice Address - Country:US
Practice Address - Phone:781-331-2442
Practice Address - Fax:781-337-8981
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA121131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice