Provider Demographics
NPI:1003459140
Name:MELISSA CERESI DMD PC
Entity Type:Organization
Organization Name:MELISSA CERESI DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEVIVINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-230-7060
Mailing Address - Street 1:960 TOWN CTR
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-5182
Mailing Address - Country:US
Mailing Address - Phone:215-230-7060
Mailing Address - Fax:215-230-7907
Practice Address - Street 1:960 TOWN CTR
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:PA
Practice Address - Zip Code:18901-5182
Practice Address - Country:US
Practice Address - Phone:215-230-7060
Practice Address - Fax:215-230-7907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty