Organization
JOSEPH A CICCIO JR DDS AND PETER B DEMAREST DMD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH ANTHONY CICCIO JR. DDS (OWNER)
(914) 337-4700
Entity
Organization
Contact information
Practice address
117 E 77TH ST APT 1A, NEW YORK, NY 10021-1823
(212) 535-0515
(212) 717-0527
Mailing address
1 PONDFIELD ROAD, SUITE 304, BRONXVILLE, NY 10708
(914) 337-4700
(914) 395-1460
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0376242
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
0457262
NY
Other
Enumeration date
12/08/2006
Last updated
08/22/2020
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