Provider Demographics
NPI:1801307319
Name:CICERO, GIUSEPPE (DDS)
Entity type:Individual
Prefix:
First Name:GIUSEPPE
Middle Name:
Last Name:CICERO
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 1:130 GRANITE ST
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-2495
Mailing Address - Country:US
Mailing Address - Phone:401-596-2848
Mailing Address - Fax:
Practice Address - Street 1:130 GRANITE ST
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-2495
Practice Address - Country:US
Practice Address - Phone:401-596-2848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN033591223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics