Individual
LOUIS COLACICCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
425 BROADHOLLOW RD, MELVILLE, NY 11747-4713
(631) 752-1033
(631) 752-1034
Mailing address
425 BROADHOLLOW RD, MELVILLE, NY 11747-4713
(631) 752-1033
(631) 752-1034
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
035856
NY
Other
Enumeration date
11/01/2006
Last updated
05/08/2008
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