Dafonseca, Marcio A
Dafonseca, Marcio A is an individual health care provider with primary practice located at 555 S. 18Th Street , Columbus OH 43205. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Dafonseca, Marcio A can be contacted via phone (614) 722-4579.Contact Information
Primary practice address
555 S. 18Th Street
Columbus OH 43205
Phone: (614) 722-4579
Fax: (614) 722-4565
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 71000193 | Ohio |
Profile Details
| NPI number | 1548353295 |
|---|---|
| LBN Legal business name | Dafonseca, Marcio A |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 2nd, 2006 |
| Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548353295 | NPPES |
| Ohio | MEDICAID | 0243972 |
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