Provider Demographics
NPI:1710239629
Name:JOSEPH DEFILIPPO DDS PC
Entity Type:Organization
Organization Name:JOSEPH DEFILIPPO DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEFILIPPO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:203-324-2566
Mailing Address - Street 1:61 4TH ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5010
Mailing Address - Country:US
Mailing Address - Phone:203-324-2566
Mailing Address - Fax:203-323-2958
Practice Address - Street 1:61 4TH ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5010
Practice Address - Country:US
Practice Address - Phone:203-324-2566
Practice Address - Fax:203-323-2958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0055021223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty