Organization
CICERO DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL BOTTY DDS (OWNER)
(315) 458-3088
Entity
Organization
Contact information
Practice address
7770 FRONTAGE RD, CICERO, NY 13039-8600
(315) 458-3088
(315) 458-5682
Mailing address
7770 FRONTAGE RD, CICERO, NY 13039-8600
(315) 458-3088
(315) 458-5682
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
031849-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00461138
—
NY
05
—
00764723
—
NY
05
—
02134018
—
NY
05
—
02587548
—
NY
05
—
02608079
—
NY
05
—
02783686
—
NY
05
—
02783746
—
NY
Enumeration date
01/02/2007
Last updated
08/22/2020
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