Provider Demographics
NPI:1497929475
Name:ANTHONY J. FIOCCA D.D.S.
Entity Type:Organization
Organization Name:ANTHONY J. FIOCCA D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:FIOCCA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:330-673-5122
Mailing Address - Street 1:908 S WATER ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-3832
Mailing Address - Country:US
Mailing Address - Phone:330-673-5122
Mailing Address - Fax:
Practice Address - Street 1:908 S WATER ST
Practice Address - Street 2:SUITE B
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-3832
Practice Address - Country:US
Practice Address - Phone:330-673-5122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-21
Last Update Date:2008-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH205311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty