| NPI | 1427118892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH ANTHONY CICCIO Owner 914-337-4700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: NY 0376242) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: NY 0457262) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2020-08-22 |