Doctor Name: | JOSEPH SACCOGNA |
NPI Number: | 1427040039 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DDS |
License Number: | 12557 |
Business Practice Address: | 1490 S Water St University Plaza Kent, OH - 442403848 |
Business Phone Number: | 3306739129 |
Business Fax Number: | 3306739305 |
Mailing Address: | 1490 S Water St, University Plaza KENT |
State: | OH |
Postal Code: | 442403848 |
Phone Number: | 3306739129 |
Fax Number: | 3306739305 |
NPI Enumeration Date: | 08/19/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 12557 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |