Provider Demographics
NPI:1013028836
Name:FINAZZO, JOSEPHINE (DMD)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:
Last Name:FINAZZO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22130 E RIVER RD
Mailing Address - Street 2:
Mailing Address - City:GROSSE ILE
Mailing Address - State:MI
Mailing Address - Zip Code:48138-1385
Mailing Address - Country:US
Mailing Address - Phone:734-675-6099
Mailing Address - Fax:
Practice Address - Street 1:19850 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-2048
Practice Address - Country:US
Practice Address - Phone:248-442-8885
Practice Address - Fax:248-442-7727
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010132491223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics