Provider Demographics
NPI:1881714962
Name:CIANDELLA, THOMAS L (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:L
Last Name:CIANDELLA
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 1:499 BECKETT RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-1766
Mailing Address - Country:US
Mailing Address - Phone:856-467-2970
Mailing Address - Fax:856-467-1352
Practice Address - Street 1:499 BECKETT RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SWEDESBORO
Practice Address - State:NJ
Practice Address - Zip Code:08085-1766
Practice Address - Country:US
Practice Address - Phone:856-467-2970
Practice Address - Fax:856-467-1352
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI162181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice