Provider Demographics
NPI:1245768589
Name:MICARONI, CYNTHIA MARY (DDS)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:MARY
Last Name:MICARONI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:MARY
Other - Last Name:DOWSLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:338 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:HERKIMER
Mailing Address - State:NY
Mailing Address - Zip Code:13350-2026
Mailing Address - Country:US
Mailing Address - Phone:315-866-2344
Mailing Address - Fax:
Practice Address - Street 1:338 E STATE ST
Practice Address - Street 2:
Practice Address - City:HERKIMER
Practice Address - State:NY
Practice Address - Zip Code:13350
Practice Address - Country:US
Practice Address - Phone:315-866-2344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2019-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0604331223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics