MEDICARE: DR. JOHN MATTHEW FIOCCA DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	30.019477	OH

General Provider Information

NPI Number	:	1497836886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN MATTHEW FIOCCA DDS

Provider Business Mailing Address
First Line	:	303 GRAHAM RD
Second Line	:
City	:	CUYAHOGA FALLS
State	:	OH
Zip	:	44223-2260
Country	:	US
Telephone Number	:	330-928-8837
Fax Number	:	330-928-1544

Provider Business Practice Location Address
First Line	:	303 GRAHAM RD
Second Line	:
City	:	CUYAHOGA FALLS
State	:	OH
Zip	:	44223-2260
Country	:	US
Telephone Number	:	330-928-8837
Fax Number	:	330-928-1544

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	07/08/2007

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