Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DS030581L | PA |
NPI | 1013068154 |
---|---|
Provider Name | Dr. Donna L Iannone |
First Address | Monaca, PA 15061-3142 |
Second Address | Monaca, PA 15061-3142 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 05/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1010560120001 | (05) | PA |
2158703 | (05) | OH |