Provider Demographics
NPI:1396958583
Name:FINAZZO, JOSEPHINE ANNA (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:JOSEPHINE
Middle Name:ANNA
Last Name:FINAZZO
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12947 NORTHLINE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-1183
Mailing Address - Country:US
Mailing Address - Phone:734-285-8600
Mailing Address - Fax:
Practice Address - Street 1:12947 NORTHLINE RD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-1111
Practice Address - Country:US
Practice Address - Phone:734-285-8666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI164011223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry