Provider Demographics
NPI:1881810943
Name:CIOFFARI, BRYAN PATRICK (DDS)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:PATRICK
Last Name:CIOFFARI
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 1:717 CEDARCREST CT
Mailing Address - Street 2:
Mailing Address - City:DUNCANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16635-7300
Mailing Address - Country:US
Mailing Address - Phone:919-452-8491
Mailing Address - Fax:
Practice Address - Street 1:1041 3RD AVE
Practice Address - Street 2:
Practice Address - City:DUNCANSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16635-1351
Practice Address - Country:US
Practice Address - Phone:814-695-0920
Practice Address - Fax:814-695-0926
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0367451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101642904-0001Medicaid