Provider Demographics
NPI:1548450562
Name:PILEGGI, GARY F (DDS)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:F
Last Name:PILEGGI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 PARK AVE N
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-3880
Mailing Address - Country:US
Mailing Address - Phone:407-628-0200
Mailing Address - Fax:407-599-9707
Practice Address - Street 1:316 PARK AVE N
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-3880
Practice Address - Country:US
Practice Address - Phone:407-628-0200
Practice Address - Fax:407-599-9707
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN-00082421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice