# DR. GIANCARLO LUCIANO GHISALBERTI

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1558856815
- **Gender:** Man
- **Credential:** DMD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 22DR03255 | NJ | Yes |
| 1223G0001X | General Practice Dentistry | 22DI02726900 | NJ | — |

## Other

- **Enumeration date:** 06/28/2018
- **Last updated:** 07/10/2019