Provider Demographics
NPI:1134131592
Name:DIBLASIO, JOSEPH D (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:D
Last Name:DIBLASIO
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 1:400 NATIONWIDE DR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-9752
Mailing Address - Country:US
Mailing Address - Phone:717-657-4400
Mailing Address - Fax:717-657-4410
Practice Address - Street 1:400 NATIONWIDE DR
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-9752
Practice Address - Country:US
Practice Address - Phone:717-657-4400
Practice Address - Fax:717-657-4410
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS015762L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery