Provider Demographics
NPI:1447301106
Name:BILOTTA, MARY CONSTANCE (DDS)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:CONSTANCE
Last Name:BILOTTA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:M. CONSTANCE
Other - Middle Name:B
Other - Last Name:GREELEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1405 SILVERSIDE RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4445
Mailing Address - Country:US
Mailing Address - Phone:302-475-4102
Mailing Address - Fax:
Practice Address - Street 1:1405 SILVERSIDE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4445
Practice Address - Country:US
Practice Address - Phone:302-475-4102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEGI-00008831223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics