Provider Demographics
NPI:1770677668
Name:SARNICOLA, JOHN ERIC I (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ERIC
Last Name:SARNICOLA
Suffix:I
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 REYNOLDS RD
Mailing Address - Street 2:APT R 6
Mailing Address - City:JOHNSON CITY
Mailing Address - State:NY
Mailing Address - Zip Code:13790-1372
Mailing Address - Country:US
Mailing Address - Phone:607-222-8085
Mailing Address - Fax:
Practice Address - Street 1:1025 REYNOLDS RD
Practice Address - Street 2:APT R 6
Practice Address - City:JOHNSON CITY
Practice Address - State:NY
Practice Address - Zip Code:13790-1372
Practice Address - Country:US
Practice Address - Phone:607-222-8085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049502122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist