Provider Demographics
NPI:1497957047
Name:FRANCISCO PICO FAZZI DDS FADSA PC THE CENTER FOR PAINLESS DENTISTRY
Entity Type:Organization
Organization Name:FRANCISCO PICO FAZZI DDS FADSA PC THE CENTER FOR PAINLESS DENTISTRY
Other - Org Name:FRANCISCO PICO FAZZI CENTER FOR PAINLESS DENTI
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:J
Authorized Official - Last Name:PICO FAZZI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:610-397-1020
Mailing Address - Street 1:649 W GERMANTOWN PIKE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1036
Mailing Address - Country:US
Mailing Address - Phone:610-397-1020
Mailing Address - Fax:610-397-1284
Practice Address - Street 1:649 W GERMANTOWN PIKE
Practice Address - Street 2:SUITE 100
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1036
Practice Address - Country:US
Practice Address - Phone:610-397-1020
Practice Address - Fax:610-397-1284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027591L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty