Provider Demographics
NPI:1467781864
Name:VECCHIO, PAUL RAYMOND (DDS)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:RAYMOND
Last Name:VECCHIO
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 1:1288 N ABBE RD
Mailing Address - Street 2:STE C
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-1679
Mailing Address - Country:US
Mailing Address - Phone:440-365-9580
Mailing Address - Fax:440-365-5617
Practice Address - Street 1:1288 N ABBE RD
Practice Address - Street 2:STE C
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-1679
Practice Address - Country:US
Practice Address - Phone:440-365-9580
Practice Address - Fax:440-365-5617
Is Sole Proprietor?:No
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30022391122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist