Mary Veronica Decicco, D.M.D.
Individual provider Active NPI General Practice Dentistry · Skillman, NJ
NPI 1720102825 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720102825
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DI012330 (NJ)
- Practice address
- 67 Tamarack Cir
Skillman, NJ 08558-2019 - Phone
- (609) 921-7744
- Fax
- (609) 921-9508
- NPI assigned
- Mar 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI012330 | NJ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sri Dental LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DI012330 | NJ | Yes |
Addresses
Primary practice location
67 Tamarack Cir
Skillman, NJ 08558-2019
Mailing address
67 Tamarack Cir
Skillman, NJ 08558-2019
Phone (609) 921-7744
Other providers in Skillman, NJ
- Peggy Ann Cummings
- Curio Digital Therapeutics Inc.
- Muneera Dahodwala
- DDK Group LLC
- Lindsay D De Flesco
- Delta Community Supports, Inc.
- Dental Center of Montgomery, LLC
- Purvi Desai
- Lisa Ann Desiato
- Designs by Dollie, L.L.C.
All providers in Skillman, NJ · General Practice Dentistry in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.