Provider Demographics
NPI:1720362668
Name:JOSEPH CARIELLO DDS PC
Entity Type:Organization
Organization Name:JOSEPH CARIELLO DDS PC
Other - Org Name:INTERLAKES FAMILY DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CARIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:603-673-6526
Mailing Address - Street 1:282 ROUTE 101
Mailing Address - Street 2:5 LIBERTY PARK
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-1706
Mailing Address - Country:US
Mailing Address - Phone:603-673-6526
Mailing Address - Fax:603-673-0417
Practice Address - Street 1:60 WHITTIER HWY
Practice Address - Street 2:UNIT 1
Practice Address - City:MOULTONBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03254-3684
Practice Address - Country:US
Practice Address - Phone:603-253-4363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty