Provider Demographics
NPI:1851499529
Name:FIASCHETTI, DAVID K (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:K
Last Name:FIASCHETTI
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 1:65 W MAIN RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842-4933
Mailing Address - Country:US
Mailing Address - Phone:401-848-0070
Mailing Address - Fax:401-848-2225
Practice Address - Street 1:65 W MAIN RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-4933
Practice Address - Country:US
Practice Address - Phone:401-848-0070
Practice Address - Fax:401-848-2225
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041673-11223S0112X
RIDEN030451223S0112X
MADN18550451223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery