Provider Demographics
NPI:1609809615
Name:GERALD A CIOFFI DMD PA
Entity Type:Organization
Organization Name:GERALD A CIOFFI DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENITST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:ALFRED
Authorized Official - Last Name:CIOFFI
Authorized Official - Suffix:II
Authorized Official - Credentials:DMD
Authorized Official - Phone:904-272-6244
Mailing Address - Street 1:767 BLANDING BLVD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-8721
Mailing Address - Country:US
Mailing Address - Phone:904-272-6244
Mailing Address - Fax:904-276-0038
Practice Address - Street 1:767 BLANDING BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32065-8721
Practice Address - Country:US
Practice Address - Phone:904-272-6244
Practice Address - Fax:904-276-0038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 115771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty