Provider Demographics
NPI:1902101652
Name:HELEN C FISCELLA DDS P.C.
Entity Type:Organization
Organization Name:HELEN C FISCELLA DDS P.C.
Other - Org Name:FISCELLA FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:FISCELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-253-0400
Mailing Address - Street 1:1161 PROFESSIONAL DR.
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185
Mailing Address - Country:US
Mailing Address - Phone:757-253-0400
Mailing Address - Fax:757-253-0083
Practice Address - Street 1:1161 PROFESSIONAL DR.
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185
Practice Address - Country:US
Practice Address - Phone:757-253-0400
Practice Address - Fax:757-253-0083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401410595122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty