Provider Demographics
NPI:1245365469
Name:SERETTI, CELSO D (DDS)
Entity type:Individual
Prefix:
First Name:CELSO
Middle Name:D
Last Name:SERETTI
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 1:935 GEMINI ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2703
Mailing Address - Country:US
Mailing Address - Phone:281-486-9440
Mailing Address - Fax:281-486-7745
Practice Address - Street 1:935 GEMINI ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2703
Practice Address - Country:US
Practice Address - Phone:281-486-9440
Practice Address - Fax:281-486-7745
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX163041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice