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Organization

JOHN M FACCIOLO D.M.D., P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN FACCIOLO DR (OWNER / DENTIST)
(302) 652-2451
Entity
Organization

Contact information

Practice address
1304 N BROOM ST, WILMINGTON, DE 19806
(302) 652-2451
Mailing address
1304 N BROOM ST, WILMINGTON, DE 19806-4266
(302) 652-2451

Taxonomy

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

Other

Enumeration date
09/13/2023
Last updated
09/13/2023
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