MEDICARE: DR. FRANK P IUORNO JR. DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	0401410390	VA

General Provider Information

NPI Number	:	1013914654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK P IUORNO JR. DDS

Provider Business Mailing Address
First Line	:	12000 WYNDHAM LAKE DRIVE
Second Line	:	SUITE C
City	:	GLEN ALLEN
State	:	VA
Zip	:	23059
Country	:	US
Telephone Number	:	804-364-8366
Fax Number	:	804-364-8346

Provider Business Practice Location Address
First Line	:	12000 WYNDHAM LAKE DR
Second Line	:	STE C
City	:	GLEN ALLEN
State	:	VA
Zip	:	23059-7072
Country	:	US
Telephone Number	:	804-364-8366
Fax Number	:	804-364-8346

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	07/08/2007

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