Individual
DR. CHARLES DICOSIMO III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MSD
Contact information
Practice address
8191 CAZENOVIA RD, MANLIUS, NY 13104-9778
(315) 692-0127
Mailing address
8191 CAZENOVIA RD, MANLIUS, NY 13104-9778
(315) 692-0127
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
059734
NY
Other
Enumeration date
01/31/2023
Last updated
01/31/2023
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