Provider Demographics
NPI:1275551285
Name:CERESI, MELISSA A (DMD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:CERESI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:
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:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030778L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist