Provider Demographics
NPI:1154422947
Name:FLORIO, SALVATORE J (DDS, MD)
Entity type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:J
Last Name:FLORIO
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 TECHNOLOGY DR
Mailing Address - Street 2:THE FACIAL SURGERY CTR, PC, STE B101
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-6337
Mailing Address - Country:US
Mailing Address - Phone:203-261-7800
Mailing Address - Fax:203-261-8778
Practice Address - Street 1:115 TECHNOLOGY DR
Practice Address - Street 2:THE FACIAL SURGERY CTR, PC, STE B101
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-6337
Practice Address - Country:US
Practice Address - Phone:203-261-7800
Practice Address - Fax:203-261-8778
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT082151223S0112X
CT035135204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT035135OtherMEDICAL LICENSE
CT008215OtherDENTAL LICENSE
CT80000003Medicare ID - Type Unspecified
CT035135OtherMEDICAL LICENSE