Provider Demographics
NPI:1316152820
Name:DIGGIN, CECILIA T (DMD)
Entity type:Individual
Prefix:DR
First Name:CECILIA
Middle Name:T
Last Name:DIGGIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 THORNWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-1840
Mailing Address - Country:US
Mailing Address - Phone:716-573-1814
Mailing Address - Fax:631-444-8680
Practice Address - Street 1:100 PATRIOTS ROAD
Practice Address - Street 2:MEDICAL SUITE
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-3300
Practice Address - Country:US
Practice Address - Phone:631-444-8526
Practice Address - Fax:631-444-8680
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049462-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice