Provider Demographics
NPI:1881392157
Name:SPALLONE FAMILY DENTISTRY & ASSOCIATES
Entity type:Organization
Organization Name:SPALLONE FAMILY DENTISTRY & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPALLONE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:772-567-5100
Mailing Address - Street 1:2166 58TH AVE
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32966-4648
Mailing Address - Country:US
Mailing Address - Phone:772-567-5100
Mailing Address - Fax:772-567-5801
Practice Address - Street 1:2166 58TH AVE
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32966-4648
Practice Address - Country:US
Practice Address - Phone:772-567-5100
Practice Address - Fax:772-567-5801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty