Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 3364 | AZ |
NPI | 1083788905 |
---|---|
Provider Name | Dr. Thomas Joesph Cipriano |
First Address | Phoenix, AZ 85048-4007 |
Second Address | Tempe, AZ 85283-3799 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 08/07/2007 |