DR. Anthony William Fazio, DDS

NPI #1205049053 in Medford, New York

Provider Information

NPI Number: 1205049053
Entity Type: Individual
Name: DR. Anthony William Fazio, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: May 8, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 2600 ROUTE 112
City: Medford
State: New York
ZIP Code: 11763
Phone: (631) 475-3345

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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