Healthcare Provider Details

I. General information

NPI: 1861645038
Provider Name (Legal Business Name): FRANCESCO PAUL VULTAGGIO D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2008
Last Update Date: 10/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2826 S UNIVERSITY DR APT: 3204
DAVIE FL
33328-1448
US

IV. Provider business mailing address

2826 S UNIVERSITY DR APT: 3204
DAVIE FL
33328-1448
US

V. Phone/Fax

Practice location:
  • Phone: 561-703-0821
  • Fax:
Mailing address:
  • Phone: 561-703-0821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN18316
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: