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5663 E Circle Dr Cicero NY 13039-8907 | |
| (315) 214-0004 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 5663 E Circle Dr, Cicero, New York |
| Authorized Official Name and Position | Stephanie Harding (OWNER) |
| Authorized Official Contact | 3152140004 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5663 E Circle Dr Cicero NY 13039-8907 Ph: (315) 214-0004 | 5663 E Circle Dr Cicero NY 13039-8907 Ph: (315) 214-0004 |
| NPI Number | 1235708124 |
|---|---|
| Provider Enumeration Date | 06/23/2021 |
| Last Update Date | 11/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235708124 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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