Provider Demographics
NPI:1255507141
Name:CICHETTI & DELLIGATTI ORTHODONTICS, P.C.
Entity Type:Organization
Organization Name:CICHETTI & DELLIGATTI ORTHODONTICS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-743-3700
Mailing Address - Street 1:6404 ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149-2943
Mailing Address - Country:US
Mailing Address - Phone:215-743-3700
Mailing Address - Fax:215-743-3706
Practice Address - Street 1:7 E SKIPPACK PIKE
Practice Address - Street 2:SUITE 105
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-5310
Practice Address - Country:US
Practice Address - Phone:215-283-2440
Practice Address - Fax:215-283-6383
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CICHETTI & DELLIGATTI ORTHODONTICS, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-01
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0020222L1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty