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General NPI Number Information
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NPI Number | 1386668051
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Entity Type | Organization
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Legal Business Name | JOHN P. CANCELLIERE & ASSOCIATES, DMD, LLC
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 02/23/2015
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Provider Practice Location Address
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Address Line | 1001 CROSSPOINTE DRIVE SUITE 2
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City | NAPLES
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State | FL
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Zip | 34110
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Country | US
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Telephone | 239-566-2422
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Fax | 239-596-6614
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Provider Business Mailing Address
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Address Line | 1001 CROSSPOINTE DRIVE SUITE 2
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City | NAPLES
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State | FL
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Zip | 34110
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Country | US
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Telephone | 239-566-2422
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Fax | 239-596-6614
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | MR. JOHN PETER CANCELLIERE
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Credential | D.M.D.
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Telephone | 239-566-2422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DN9163
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DN9217
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN15942
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License Number State | FL
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