# VINCENT I. DISALVO, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003044264
- **Authorized official:** DR. VINCENT I DISALVO D.D.S. (PRESIDENT)
- **Authorized official phone:** (570) 322-4741

## Contact information

- **Practice address:** 121 E 4TH ST, WILLIAMSPORT, PA 17701-6303
- **Practice address phone:** (570) 322-4741
- **Practice address fax:** (570) 323-6110
- **Mailing address:** 121 E 4TH ST, WILLIAMSPORT, PA 17701-6303
- **Mailing address phone:** (570) 322-4741
- **Mailing address fax:** (570) 323-6110

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DS015354L | PA | Yes |

## Other

- **Enumeration date:** 06/26/2009
- **Last updated:** 06/26/2009