Provider Demographics
NPI:1235793951
Name:DANIEL A. CAMPOLIETO, D.D.S., P.L.L.C.
Entity Type:Organization
Organization Name:DANIEL A. CAMPOLIETO, D.D.S., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPOLIETO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-279-4549
Mailing Address - Street 1:615 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MC ADENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28101-4503
Mailing Address - Country:US
Mailing Address - Phone:304-279-4549
Mailing Address - Fax:
Practice Address - Street 1:745 BILTMORE AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2556
Practice Address - Country:US
Practice Address - Phone:304-279-4549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-29
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty