Individual
DR. VINCENT PAUL VISSICHELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
73 PINERIDGE COVE, SANFORD, NC 27332
(919) 499-4408
Mailing address
73 PINERIDGE COVE, SANFORD, NC 27332
(919) 499-4408
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
8363
NC
1223P0221X
Pediatric Dentistry
D3481
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8363
DENTAL LICENCE
NC
01
—
D3481
DENTAL LICENSE
AZ
Enumeration date
12/27/2005
Last updated
09/30/2011
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