Provider Demographics
NPI:1629441415
Name:GIOVANNI P. IUCULANO, DDS., PC
Entity Type:Organization
Organization Name:GIOVANNI P. IUCULANO, DDS., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GIOVANNI
Authorized Official - Middle Name:P
Authorized Official - Last Name:IUCULANO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:540-662-4866
Mailing Address - Street 1:212 LINDEN DR
Mailing Address - Street 2:STE. #150
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2894
Mailing Address - Country:US
Mailing Address - Phone:540-662-4866
Mailing Address - Fax:540-662-5145
Practice Address - Street 1:212 LINDEN DR
Practice Address - Street 2:STE. #150
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2894
Practice Address - Country:US
Practice Address - Phone:540-662-4866
Practice Address - Fax:540-662-5145
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:POTOMAC VALLEY DENTAL CARE, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty