Provider Demographics
NPI:1871607895
Name:FIASCONARO, HONEY RUSSELL (DDS)
Entity type:Individual
Prefix:MRS
First Name:HONEY
Middle Name:RUSSELL
Last Name:FIASCONARO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 GOLDEN LEAF DR
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360
Mailing Address - Country:US
Mailing Address - Phone:318-729-6205
Mailing Address - Fax:
Practice Address - Street 1:3200 MONROE HWY
Practice Address - Street 2:SUITE 150
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-8110
Practice Address - Country:US
Practice Address - Phone:318-640-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA57541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice