Provider Demographics
NPI:1457477192
Name:JOSEPH R. LOIACONO JR. DDS,PC
Entity Type:Organization
Organization Name:JOSEPH R. LOIACONO JR. DDS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:LOIACONO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:570-383-2411
Mailing Address - Street 1:764 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PECKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18452-2342
Mailing Address - Country:US
Mailing Address - Phone:570-383-2411
Mailing Address - Fax:570-383-6954
Practice Address - Street 1:764 MAIN ST
Practice Address - Street 2:
Practice Address - City:PECKVILLE
Practice Address - State:PA
Practice Address - Zip Code:18452-2342
Practice Address - Country:US
Practice Address - Phone:570-383-2411
Practice Address - Fax:570-383-6954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS017163L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty