Provider Demographics
NPI:1144285222
Name:COLUCCIO, ROSANNE PATRICE (DDS)
Entity type:Individual
Prefix:DR
First Name:ROSANNE
Middle Name:PATRICE
Last Name:COLUCCIO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 ALBANY SHAKER RD STE 201
Mailing Address - Street 2:
Mailing Address - City:LOUDONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12211-1970
Mailing Address - Country:US
Mailing Address - Phone:518-438-1131
Mailing Address - Fax:518-438-9490
Practice Address - Street 1:399 ALBANY SHAKER RD STE 201
Practice Address - Street 2:
Practice Address - City:LOUDONVILLE
Practice Address - State:NY
Practice Address - Zip Code:12211-1970
Practice Address - Country:US
Practice Address - Phone:518-438-1131
Practice Address - Fax:518-438-9490
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061028122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist