Provider Demographics
NPI:1700263233
Name:PETER C CERTO JR DMD
Entity Type:Organization
Organization Name:PETER C CERTO JR DMD
Other - Org Name:CERTO DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:CARMEN
Authorized Official - Last Name:CERTO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-364-1345
Mailing Address - Street 1:2940A CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:ASTON
Mailing Address - State:PA
Mailing Address - Zip Code:19014-2943
Mailing Address - Country:US
Mailing Address - Phone:610-364-1345
Mailing Address - Fax:610-364-1347
Practice Address - Street 1:2940 CONCORD RD
Practice Address - Street 2:A
Practice Address - City:ASTON
Practice Address - State:PA
Practice Address - Zip Code:19014-2943
Practice Address - Country:US
Practice Address - Phone:610-364-1345
Practice Address - Fax:610-364-1347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-05
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028538L332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies