Provider Demographics
NPI:1881954998
Name:DENTAL CARE DELIVERED
Entity type:Organization
Organization Name:DENTAL CARE DELIVERED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MONTICCIOLO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,MBA
Authorized Official - Phone:727-422-2801
Mailing Address - Street 1:1214 PLAYMOOR DR
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-1471
Mailing Address - Country:US
Mailing Address - Phone:727-422-2801
Mailing Address - Fax:727-945-9661
Practice Address - Street 1:1214 PLAYMOOR DR
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-1471
Practice Address - Country:US
Practice Address - Phone:727-422-2801
Practice Address - Fax:727-945-9661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN014899122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty