Provider Demographics
NPI:1689893240
Name:CETTA, CHRISTOPHER NEIL (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:NEIL
Last Name:CETTA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 NINA PL
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-2814
Mailing Address - Country:US
Mailing Address - Phone:973-895-5069
Mailing Address - Fax:
Practice Address - Street 1:2929 KLOCKNER RD
Practice Address - Street 2:
Practice Address - City:HAMILTON SQUARE
Practice Address - State:NJ
Practice Address - Zip Code:08690-2809
Practice Address - Country:US
Practice Address - Phone:609-586-6603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI023177001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics