Provider Demographics
NPI:1518379114
Name:CIKA, ENTELA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ENTELA
Middle Name:
Last Name:CIKA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 ESSEX ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01840-1549
Mailing Address - Country:US
Mailing Address - Phone:978-837-4444
Mailing Address - Fax:978-327-5315
Practice Address - Street 1:234 ESSEX ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1549
Practice Address - Country:US
Practice Address - Phone:978-837-4444
Practice Address - Fax:978-327-5315
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-30
Last Update Date:2014-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18565511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice