Provider Demographics
NPI:1871608927
Name:VRONA, DOUGLAS GENE (DMD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:GENE
Last Name:VRONA
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 1:23 REED RD
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:MA
Mailing Address - Zip Code:02790-1135
Mailing Address - Country:US
Mailing Address - Phone:508-636-3044
Mailing Address - Fax:508-636-6433
Practice Address - Street 1:23 REED RD
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:MA
Practice Address - Zip Code:02790-1135
Practice Address - Country:US
Practice Address - Phone:508-636-3044
Practice Address - Fax:508-636-6433
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA124201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAX03950OtherBLUE CROSS/BLUE SHIELD
MAX03950OtherBLUE CROSS/BLUE SHIELD