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Individual

DR. FRANK IACONO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
72 ALLEN ST, RUTLAND, VT 05701-4568
(802) 775-7440
Mailing address
76 COLONIAL DR, RUTLAND, VT 05701-9572
(802) 775-1164

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
813
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
813
VERMONT STATE LICENSE
VT
Enumeration date
08/01/2006
Last updated
06/19/2008
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