Provider Demographics
NPI:1932131091
Name:CILLO, JOSEPH EDWARD JR
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:EDWARD
Last Name:CILLO
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 MOUNT LEBANON BLVD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15234-1511
Mailing Address - Country:US
Mailing Address - Phone:412-563-7707
Mailing Address - Fax:412-569-0970
Practice Address - Street 1:305 MOUNT LEBANON BLVD
Practice Address - Street 2:SUITE 305
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15234-1511
Practice Address - Country:US
Practice Address - Phone:412-563-7707
Practice Address - Fax:412-569-0970
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030877L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery