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General NPI Number Information
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NPI Number | 1306075858
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Entity Type | Individual
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Provider Name | ANTONIO LEE PICCIANO D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/06/2009
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Last Update Date | 12/27/2012
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Provider Practice Location Address
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Address Line | 1201 S HIGH ST
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City | COLUMBUS
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State | OH
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Zip | 43206-3400
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Country | US
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Telephone | 614-258-3880
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Fax |
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Provider Business Mailing Address
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Address Line | 6790 PERIMETER DR SUITE 100
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City | DUBLIN
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State | OH
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Zip | 43016-8063
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Country | US
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Telephone | 614-717-3500
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Fax | 614-717-0933
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30-023063
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License Number State | OH
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