Provider Demographics
NPI:1902695737
Name:ZECCOLA, AMANDA MADISON (DDS)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:MADISON
Last Name:ZECCOLA
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 THRUSH FIELD WAY
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-9526
Mailing Address - Country:US
Mailing Address - Phone:585-746-5696
Mailing Address - Fax:
Practice Address - Street 1:165 CAMBRIDGE ST STE 401
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2750
Practice Address - Country:US
Practice Address - Phone:617-726-1076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program