Provider Demographics
NPI:1912087396
Name:DECARLO, FRANCESCO R (DDS)
Entity type:Individual
Prefix:
First Name:FRANCESCO
Middle Name:R
Last Name:DECARLO
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 1:110 N MILLER RD
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3704
Mailing Address - Country:US
Mailing Address - Phone:330-864-9090
Mailing Address - Fax:330-864-2626
Practice Address - Street 1:110 N MILLER RD
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3704
Practice Address - Country:US
Practice Address - Phone:330-864-9090
Practice Address - Fax:330-864-2626
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH188461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice