Provider Demographics
NPI:1508072778
Name:FORCELLA, BRUNO A (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRUNO
Middle Name:A
Last Name:FORCELLA
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 1:280 MAMARONECK AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605
Mailing Address - Country:US
Mailing Address - Phone:914-946-1923
Mailing Address - Fax:914-946-0559
Practice Address - Street 1:280 MAMARONECK AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605
Practice Address - Country:US
Practice Address - Phone:914-946-1923
Practice Address - Fax:914-946-0559
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0357501223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics