Organization
MARIGOLD PEDIATRIC DENTISTRY AND ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELENA CICIOLLA DMD (OWNER)
(954) 691-7906
Entity
Organization
Contact information
Practice address
1713 SPRINGFIELD AVE, MAPLEWOOD, NJ 07040-2914
(973) 821-7161
Mailing address
180 OLD TAPPAN RD STE 1A, OLD TAPPAN, NJ 07675-7052
(973) 821-7161
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
05/05/2020
Last updated
01/11/2024
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