Provider Demographics
NPI:1639330574
Name:DELALLO, SANTO A (DMD)
Entity Type:Individual
Prefix:DR
First Name:SANTO
Middle Name:A
Last Name:DELALLO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 W NORWALK RD
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-4405
Mailing Address - Country:US
Mailing Address - Phone:203-855-8877
Mailing Address - Fax:203-899-0221
Practice Address - Street 1:122 W NORWALK RD
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-4405
Practice Address - Country:US
Practice Address - Phone:203-855-8877
Practice Address - Fax:203-899-0221
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT71201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice