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NPI Code Detail

MEDICARE: DR. SAARA KYLLIKKI NIEMINEN-CISNEROS DMD

MEDICARE:  DR. SAARA KYLLIKKI NIEMINEN-CISNEROS  DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDI017870NJ

General Provider Information

NPI Number : 1881716793
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAARA KYLLIKKI NIEMINEN-CISNEROS DMD
Provider Business Mailing Address
First Line : 319 MAIN ST
Second Line : STE B-2
City : KEANSBURG
State : NJ
Zip : 07734-2063
Country : US
Telephone Number : 732-495-8600
Fax Number : 732-495-0907
Provider Business Practice Location Address
First Line : 319 MAIN ST
Second Line : STE B-2
City : KEANSBURG
State : NJ
Zip : 07734-2063
Country : US
Telephone Number : 732-495-8600
Fax Number : 732-495-0907
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2007
Last Update Date : 07/08/2007

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Directions to “ DR. SAARA KYLLIKKI NIEMINEN-CISNEROS DMD” Practice Location

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