Healthcare Provider Details

I. General information

NPI: 1902646573
Provider Name (Legal Business Name): GEORGE P CERNIGLIA A PROFESSIONAL DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2024
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3320 HESSMER AVE
METAIRIE LA
70002-4727
US

IV. Provider business mailing address

3320 HESSMER AVE
METAIRIE LA
70002-4727
US

V. Phone/Fax

Practice location:
  • Phone: 504-454-5880
  • Fax: 504-454-8332
Mailing address:
  • Phone: 504-454-5880
  • Fax: 504-454-8332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. GEORGE P CERNIGLIA
Title or Position: DENTIST/OWNER
Credential: DDS
Phone: 504-454-5880