Provider Demographics
NPI:1023228939
Name:LOUIS M FUOCO DDS PC
Entity type:Organization
Organization Name:LOUIS M FUOCO DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:FUOCO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:845-246-4977
Mailing Address - Street 1:137 BURT ST
Mailing Address - Street 2:RT 9W
Mailing Address - City:SAUGERTIES
Mailing Address - State:NY
Mailing Address - Zip Code:12477-1952
Mailing Address - Country:US
Mailing Address - Phone:845-246-4977
Mailing Address - Fax:
Practice Address - Street 1:137 BURT ST
Practice Address - Street 2:RT 9W
Practice Address - City:SAUGERTIES
Practice Address - State:NY
Practice Address - Zip Code:12477-1952
Practice Address - Country:US
Practice Address - Phone:845-246-4977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0413791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty