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General NPI Number Information
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NPI Number | 1457477192
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Entity Type | Organization
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Legal Business Name | JOSEPH R. LOIACONO JR. DDS,PC
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 764 MAIN ST
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City | PECKVILLE
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State | PA
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Zip | 18452-2342
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Country | US
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Telephone | 570-383-2411
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Fax | 570-383-6954
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Provider Business Mailing Address
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Address Line | 764 MAIN ST
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City | PECKVILLE
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State | PA
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Zip | 18452-2342
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Country | US
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Telephone | 570-383-2411
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Fax | 570-383-6954
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Authorized Official
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Title or Position | PRESIDENT OF CORPORATION
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Name | DR. JOSEPH R LOIACONO
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Credential | DDS
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Telephone | 570-383-2411
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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 | DS017163L
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License Number State | PA
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