Healthcare Provider Details

I. General information

NPI: 1346369055
Provider Name (Legal Business Name): TONIANNE CIFRODELLI D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 09/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1641 MAHAN CENTER BLVD # 1
TALLAHASSEE FL
32308-5454
US

IV. Provider business mailing address

1641 MAHAN CENTER BLVD STE 1
TALLAHASSEE FL
32308-7404
US

V. Phone/Fax

Practice location:
  • Phone: 850-309-0333
  • Fax: 850-309-1093
Mailing address:
  • Phone: 850-309-0333
  • Fax: 850-309-1093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN15910
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: