Provider Demographics
NPI:1568452639
Name:PASCOE, DAVID FRANK (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:FRANK
Last Name:PASCOE
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:PO BOX 1198
Mailing Address - Street 2:
Mailing Address - City:SOUTHOLD
Mailing Address - State:NY
Mailing Address - Zip Code:11971-0934
Mailing Address - Country:US
Mailing Address - Phone:631-765-1919
Mailing Address - Fax:631-614-7852
Practice Address - Street 1:51100 MAIN RD
Practice Address - Street 2:
Practice Address - City:SOUTHOLD
Practice Address - State:NY
Practice Address - Zip Code:11971-4655
Practice Address - Country:US
Practice Address - Phone:631-765-1919
Practice Address - Fax:631-614-7852
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-28
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0325901223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics