Provider Demographics
NPI:1265542823
Name:CECERE, JOSEPH L (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:L
Last Name:CECERE
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 1:620 SHREWSBURY AVE
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4915
Mailing Address - Country:US
Mailing Address - Phone:732-747-9377
Mailing Address - Fax:732-741-0623
Practice Address - Street 1:620 SHREWSBURY AVE
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07701-4915
Practice Address - Country:US
Practice Address - Phone:732-747-9377
Practice Address - Fax:732-741-0623
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI016952001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice