Provider Demographics
NPI:1831394139
Name:FIORILLO, DAVID J
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:FIORILLO
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:J
Other - Last Name:FIORILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:16 HILLCREST PKWY
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1427
Mailing Address - Country:US
Mailing Address - Phone:978-686-8500
Mailing Address - Fax:978-686-4032
Practice Address - Street 1:16 HILLCREST PKWY
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-1427
Practice Address - Country:US
Practice Address - Phone:978-686-8500
Practice Address - Fax:978-686-4032
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20413122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist