Organization
VINCENT I. DISALVO, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINCENT I DISALVO D.D.S. (PRESIDENT)
(570) 322-4741
Entity
Organization
Contact information
Practice address
121 E 4TH ST, WILLIAMSPORT, PA 17701-6303
(570) 322-4741
(570) 323-6110
Mailing address
121 E 4TH ST, WILLIAMSPORT, PA 17701-6303
(570) 322-4741
(570) 323-6110
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS015354L
PA
Other
Enumeration date
06/26/2009
Last updated
06/26/2009
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