Provider Demographics
NPI:1467663294
Name:SCLAFANI, ROSOLINO VINCENT (DDS,MD)
Entity Type:Individual
Prefix:DR
First Name:ROSOLINO
Middle Name:VINCENT
Last Name:SCLAFANI
Suffix:
Gender:M
Credentials:DDS,MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37251 WILLOW LN
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48036-3667
Mailing Address - Country:US
Mailing Address - Phone:586-362-4544
Mailing Address - Fax:
Practice Address - Street 1:7815 E JEFFERSON AVE
Practice Address - Street 2:SUITE 2B
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48214-3704
Practice Address - Country:US
Practice Address - Phone:313-499-4775
Practice Address - Fax:313-499-4908
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010192571223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery