Provider Demographics
NPI:1093493710
Name:DINICOLA, GIACOMO A (DMD)
Entity Type:Individual
Prefix:
First Name:GIACOMO
Middle Name:A
Last Name:DINICOLA
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 1:1226 CRESTFIELD DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-9333
Mailing Address - Country:US
Mailing Address - Phone:570-360-0814
Mailing Address - Fax:
Practice Address - Street 1:253 HERSHEY RD
Practice Address - Street 2:
Practice Address - City:HUMMELSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17036-9246
Practice Address - Country:US
Practice Address - Phone:717-220-1792
Practice Address - Fax:717-220-1796
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0442311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice