Provider Demographics
NPI:1083869457
Name:CALDERONE, JOSEPH V JR (DMD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:V
Last Name:CALDERONE
Suffix:JR
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 1:415 SUMMERHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:DEBARY
Mailing Address - State:FL
Mailing Address - Zip Code:32713-2716
Mailing Address - Country:US
Mailing Address - Phone:386-668-8600
Mailing Address - Fax:386-668-0031
Practice Address - Street 1:415 SUMMERHAVEN DR
Practice Address - Street 2:
Practice Address - City:DEBARY
Practice Address - State:FL
Practice Address - Zip Code:32713-2716
Practice Address - Country:US
Practice Address - Phone:386-668-8600
Practice Address - Fax:386-668-0031
Is Sole Proprietor?:No
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9410122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist