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General NPI Number Information
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NPI Number | 1619058831
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Entity Type | Organization
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Legal Business Name | CIROCCO DENTAL CENTER PC
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 04/23/2020
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Provider Practice Location Address
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Address Line | 5280 ROUTE 309
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City | CENTER VALLEY
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State | PA
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Zip | 18034-1803
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Country | US
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Telephone | 610-282-1278
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Fax |
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Provider Business Mailing Address
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Address Line | 5280 ROUTE 309
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City | CENTER VALLEY
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State | PA
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Zip | 18034-8219
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Country | US
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Telephone | 610-282-1278
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Fax | 484-863-4933
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Authorized Official
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Title or Position | PRESIDENT / C.E.O.
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Name | DR. DEAN LOUIS CIROCCO
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Credential | D.M.D.
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Telephone | 610-282-1278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DS031336L
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License Number State | PA
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