Healthcare Provider Details

I. General information

NPI: 1962481507
Provider Name (Legal Business Name): ANDA CIORA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 03/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 S WARREN ST
DOVER NJ
07801-4506
US

IV. Provider business mailing address

326 MURRAY AVE
ENGLEWOOD NJ
07631-1420
US

V. Phone/Fax

Practice location:
  • Phone: 973-328-9100
  • Fax:
Mailing address:
  • Phone: 201-567-4603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number02059
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: