Provider Demographics
NPI:1548427842
Name:FINAZZO, VINCENT J (DDS)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:J
Last Name:FINAZZO
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 1:12985 NORTHLINE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-1182
Mailing Address - Country:US
Mailing Address - Phone:734-285-8600
Mailing Address - Fax:
Practice Address - Street 1:12985 NORTHLINE ROAD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-1182
Practice Address - Country:US
Practice Address - Phone:734-285-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI89841223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics