Provider Demographics
NPI:1871960757
Name:VULTAGGIO DENTISTRY OF CORAL SPRINGS,LLC
Entity type:Organization
Organization Name:VULTAGGIO DENTISTRY OF CORAL SPRINGS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANCESCO
Authorized Official - Middle Name:
Authorized Official - Last Name:VULTAGGIO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-840-1940
Mailing Address - Street 1:10339 W SAMPLE RD
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-3941
Mailing Address - Country:US
Mailing Address - Phone:954-840-1940
Mailing Address - Fax:954-840-1941
Practice Address - Street 1:10339 W SAMPLE RD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-3941
Practice Address - Country:US
Practice Address - Phone:954-840-1940
Practice Address - Fax:954-840-1941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-27
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18316261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental