Provider Demographics
NPI:1427183060
Name:VIGNOGNA, CHRISTOPHER PETER (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:PETER
Last Name:VIGNOGNA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4939 BRITTONFIELD PKWY
Mailing Address - Street 2:SUITE 207
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-9208
Mailing Address - Country:US
Mailing Address - Phone:315-634-6650
Mailing Address - Fax:315-634-6650
Practice Address - Street 1:4939 BRITTONFIELD PKWY
Practice Address - Street 2:SUITE 207
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9208
Practice Address - Country:US
Practice Address - Phone:315-634-6650
Practice Address - Fax:315-634-6650
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04465111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice