Provider Demographics
NPI:1164575213
Name:CHENET, CEDRIC C (DDS)
Entity Type:Individual
Prefix:DR
First Name:CEDRIC
Middle Name:C
Last Name:CHENET
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7331 OFFICE PARK PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-8239
Mailing Address - Country:US
Mailing Address - Phone:321-253-3136
Mailing Address - Fax:321-253-6411
Practice Address - Street 1:7331 OFFICE PARK PL
Practice Address - Street 2:SUITE 100
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-8239
Practice Address - Country:US
Practice Address - Phone:321-253-3136
Practice Address - Fax:321-253-6411
Is Sole Proprietor?:No
Enumeration Date:2007-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN133491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice