Provider Demographics
NPI:1922790336
Name:SERIO, CAROLYN GRACE (DMD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:GRACE
Last Name:SERIO
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 1:117 OAK HILL DR
Mailing Address - Street 2:
Mailing Address - City:ARCHBALD
Mailing Address - State:PA
Mailing Address - Zip Code:18403-1556
Mailing Address - Country:US
Mailing Address - Phone:570-955-7038
Mailing Address - Fax:
Practice Address - Street 1:517 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH ABINGTON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18411-9024
Practice Address - Country:US
Practice Address - Phone:570-587-1196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0431811223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty