Individual
JOHN FACCIOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1304 N BROOM ST, WILMINGTON, DE 19806-4266
(302) 652-2451
Mailing address
504 THORNDALE DR, HOCKESSIN, DE 19707-2332
(302) 584-6088
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
G1-0011491
DE
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2020
Last updated
05/08/2024
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