Provider Demographics
NPI:1851812838
Name:LOCASCIO, VINCENT ROBERT (DMD)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:ROBERT
Last Name:LOCASCIO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8101 LAGUNA BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-8203
Mailing Address - Country:US
Mailing Address - Phone:916-683-4333
Mailing Address - Fax:
Practice Address - Street 1:8101 LAGUNA BLVD STE 1
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-8203
Practice Address - Country:US
Practice Address - Phone:209-879-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1022091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice