Provider Demographics
NPI:1629021894
Name:CIOCCIA, BART (DDS)
Entity Type:Individual
Prefix:DR
First Name:BART
Middle Name:
Last Name:CIOCCIA
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 1:1 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:HAYDENVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:01039-9710
Mailing Address - Country:US
Mailing Address - Phone:413-268-8333
Mailing Address - Fax:
Practice Address - Street 1:1795 MAIN ST
Practice Address - Street 2:BAYSTATE DENTAL SUITE 215
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103-1015
Practice Address - Country:US
Practice Address - Phone:413-733-5700
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA204231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice