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General NPI Number Information
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NPI Number | 1104909431
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Entity Type | Individual
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Provider Name | JOHN F. CERASO DMD
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Gender | Male
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 125 MURRAY HILL RD STE A
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-6299
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Country | US
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Telephone | 910-692-5250
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Fax | 910-693-8072
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Provider Business Mailing Address
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Address Line | 125 MURRAY HILL RD STE A
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-6299
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Country | US
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Telephone | 910-692-5250
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Fax | 910-693-8072
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7562
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS027256L
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License Number State | PA
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