Provider Demographics
NPI:1730207077
Name:VASALLO, FRANCISCO (DDS)
Entity type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:
Last Name:VASALLO
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 1:8782A SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3201
Mailing Address - Country:US
Mailing Address - Phone:305-552-5340
Mailing Address - Fax:305-552-5985
Practice Address - Street 1:8782A SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-3201
Practice Address - Country:US
Practice Address - Phone:305-552-5340
Practice Address - Fax:305-552-5985
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00117221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice