Provider Demographics
NPI:1598778037
Name:CERVONE, FRANK J (DMD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:J
Last Name:CERVONE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:474 JACKSONVILLE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-3812
Mailing Address - Country:US
Mailing Address - Phone:904-241-1544
Mailing Address - Fax:904-241-1730
Practice Address - Street 1:474 JACKSONVILLE DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-3812
Practice Address - Country:US
Practice Address - Phone:904-241-1544
Practice Address - Fax:904-241-1730
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL90981223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics