Provider Demographics
NPI:1851833677
Name:FRANCESCO VULTAGGIO DMD LLC
Entity type:Organization
Organization Name:FRANCESCO VULTAGGIO DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCESCO
Authorized Official - Middle Name:
Authorized Official - Last Name:VULTAGGIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-421-2122
Mailing Address - Street 1:841 SE 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-5609
Mailing Address - Country:US
Mailing Address - Phone:954-421-2122
Mailing Address - Fax:
Practice Address - Street 1:841 SE 8TH AVE
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-5609
Practice Address - Country:US
Practice Address - Phone:954-421-2122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN183161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty