Provider Demographics
NPI:1063462562
Name:IOVINO, WILLIAM MICHAEL (DMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MICHAEL
Last Name:IOVINO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4055 MONROEVILLE BLVD
Mailing Address - Street 2:SUITE 315
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2522
Mailing Address - Country:US
Mailing Address - Phone:412-372-0580
Mailing Address - Fax:412-373-9243
Practice Address - Street 1:4055 MONROEVILLE BLVD
Practice Address - Street 2:SUITE 315
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2522
Practice Address - Country:US
Practice Address - Phone:412-372-0580
Practice Address - Fax:412-373-9243
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAD5020746L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
T27604Medicare UPIN