Provider Demographics
NPI:1063562536
Name:D'AGROSA, JOSEPH SAVORIO (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:SAVORIO
Last Name:D'AGROSA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 ROUTE 25A
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-2625
Mailing Address - Country:US
Mailing Address - Phone:631-744-0202
Mailing Address - Fax:631-744-0257
Practice Address - Street 1:555 ROUTE 25A
Practice Address - Street 2:
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-2625
Practice Address - Country:US
Practice Address - Phone:631-744-0202
Practice Address - Fax:631-744-0257
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027486122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist