Provider Demographics
NPI:1760425904
Name:CUOMO, CHRISTOPHER JOSEPH (DDS, MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JOSEPH
Last Name:CUOMO
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 CANNON DR
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-1751
Mailing Address - Country:US
Mailing Address - Phone:919-360-7098
Mailing Address - Fax:
Practice Address - Street 1:EDGEWOOD PROFESSIONAL CENTER
Practice Address - Street 2:27 HOSPITAL AVE., SUITE 306
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810
Practice Address - Country:US
Practice Address - Phone:203-797-0008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0095611223S0112X
NY051027-11223S0112X
NC071221223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery