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General NPI Number Information
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NPI Number | 1679453930
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Entity Type | Organization
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Legal Business Name | GIACCONE DENTAL PLLC
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Dates
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Enumeration Date | 09/05/2025
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 50 STANIFORD ST
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City | BOSTON
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State | MA
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Zip | 02114-2517
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Country | US
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Telephone | 929-556-0394
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Fax |
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Provider Business Mailing Address
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Address Line | 11 MOSELEY ST APT 3
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City | DORCHESTER
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State | MA
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Zip | 02125-1361
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Country | US
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Telephone | 929-556-0394
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Fax |
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Authorized Official
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Title or Position | PROSTHODONTIST
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Name | ZACHARY GIACCONE
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Credential | DMD
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Telephone | 929-556-0394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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