Basic Information
Provider Information
NPI: 1003002635
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANCONERI
FirstName: JOHN
MiddleName: ANTHONY
NamePrefix: DR.
NameSuffix:  
Credential: DMD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1038 BROADWAY
Address2:  
City: BAYONNE
State: NJ
PostalCode: 07002
CountryCode: US
TelephoneNumber: 2013391535
FaxNumber:  
Practice Location
Address1: 1038 BROADWAY
Address2:  
City: BAYONNE
State: NJ
PostalCode: 07002
CountryCode: US
TelephoneNumber: 2013391535
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/18/2007
LastUpdateDate: 09/18/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
122300000X22DI01472700NJY Dental ProvidersDentist 

No ID Information.


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