| Joseph Ceravolo Dds Inc | |
|
1304 15th St Ste 314 Santa Monica CA 90404-1809 | |
| (310) 394-5879 | |
| Not Available |
| Full Name | Joseph Ceravolo Dds Inc |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 1304 15th St, Santa Monica, California |
| Authorized Official Name and Position | Joseph Ceravolo (CEO) |
| Authorized Official Contact | 3109901636 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Joseph Ceravolo Dds Inc 322 Culver Blvd Ste #274 Playa Del Rey CA 90293-7704 Ph: (310) 990-1636 | Joseph Ceravolo Dds Inc 1304 15th St Ste 314 Santa Monica CA 90404-1809 Ph: (310) 394-5879 |
| NPI Number | 1457521361 |
|---|---|
| Provider Enumeration Date | 03/06/2008 |
| Last Update Date | 03/06/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457521361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 48513 (California) | Primary |
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