Provider Demographics
NPI:1114989928
Name:RUOCCO, DANIELLE A (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:A
Last Name:RUOCCO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 COLUMBINE CT
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-4900
Mailing Address - Country:US
Mailing Address - Phone:914-302-2892
Mailing Address - Fax:
Practice Address - Street 1:10 FISKE PL
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-3205
Practice Address - Country:US
Practice Address - Phone:914-302-2892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY504631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice