Provider Demographics
NPI:1235463233
Name:DE PASQUALE, FRANCIS L (DMD)
Entity Type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:L
Last Name:DE PASQUALE
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 1:110 PULASKI RD
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-2420
Mailing Address - Country:US
Mailing Address - Phone:631-261-0567
Mailing Address - Fax:
Practice Address - Street 1:110 PULASKI RD
Practice Address - Street 2:
Practice Address - City:EAST NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-2420
Practice Address - Country:US
Practice Address - Phone:631-261-0567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY274541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice