Healthcare Provider Details

I. General information

NPI: 1598814907
Provider Name (Legal Business Name): FRANK ANTHONY VIGLIOTTI D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 FOX ST SUITE 201
POUGHKEEPSIE NY
12601-4714
US

IV. Provider business mailing address

29 FOX ST SUITE 201
POUGHKEEPSIE NY
12601-4714
US

V. Phone/Fax

Practice location:
  • Phone: 845-471-5215
  • Fax: 845-485-1772
Mailing address:
  • Phone: 845-471-5215
  • Fax: 845-485-1772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number045984-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: