Individual
ELENA CICIOLLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
506 6TH ST, DEPARTMENT OF DENTAL MEDICINE, BROOKLYN, NY 11215-3609
(718) 780-5412
Mailing address
506 6TH ST, DEPARTMENT OF DENTAL MEDICINE, BROOKLYN, NY 11215-3609
(718) 780-5412
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
058493
NY
122300000X
Dentist
22DI02738600
NJ
1223P0221X
Pediatric Dentistry
Primary
06799
NJ
Other
Enumeration date
07/08/2015
Last updated
01/11/2024
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