Provider Demographics
NPI:1770794281
Name:DELCAMPO, JOHN AVELINO (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:AVELINO
Last Name:DELCAMPO
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 1:49 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:ALFRED
Mailing Address - State:NY
Mailing Address - Zip Code:14802-1007
Mailing Address - Country:US
Mailing Address - Phone:607-587-8838
Mailing Address - Fax:607-587-9211
Practice Address - Street 1:49 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:ALFRED
Practice Address - State:NY
Practice Address - Zip Code:14802-1007
Practice Address - Country:US
Practice Address - Phone:607-587-8838
Practice Address - Fax:607-587-9211
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0273451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice