Organization Name: | DOMINICK TRINCA, M.D. PA |
NPI Number: | 1053550236 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DOMINICK TRINCA (PRESIDENT) |
Mailing Address: | 1440 Highway 1 S Greenville |
State: | MS US |
Postal Code: | 387017140 |
Phone Number: | 6628204363 |
Fax Number: | |
NPI Enumeration Date: | 02/12/2009 |
NPI Last Update Date: | 02/12/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |