| Doctor Name: | DR. JOSEPH A ILACQUA |
| NPI Number: | 1396762308 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DDS |
| License Number: | DS022706L |
| Business Practice Address: | 2603 Dekalb Pike Norristown, PA - 19401 |
| Business Phone Number: | 6102750500 |
| Business Fax Number: | 6102751054 |
| Mailing Address: | 2603 Dekalb Pike, NORRISTOWN |
| State: | PA |
| Postal Code: | 19401 |
| Phone Number: | 6102750500 |
| Fax Number: | 6102751054 |
| NPI Enumeration Date: | 07/16/2006 |
| NPI Last Update Date: | 07/01/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204E00000X |
| License Number: | DS022706L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Oral & Maxillofacial Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |