Provider Demographics
NPI:1376169987
Name:CARCIONE, CHRISTIAN FRANK (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:FRANK
Last Name:CARCIONE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 GINGER LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-2207
Mailing Address - Country:US
Mailing Address - Phone:201-675-5894
Mailing Address - Fax:
Practice Address - Street 1:300 LEXINGTON RD STE 220
Practice Address - Street 2:
Practice Address - City:SWEDESBORO
Practice Address - State:NJ
Practice Address - Zip Code:08085-1278
Practice Address - Country:US
Practice Address - Phone:856-888-9310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-19
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02800200122300000X, 1223G0001X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No122300000XDental ProvidersDentist
Yes1223G0001XDental ProvidersDentistGeneral Practice