# DR. ALFRED JOSEPH CERTOSIMO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1770736563
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 0401008264 | VA | Yes |

## Other

- **Enumeration date:** 10/24/2008
- **Last updated:** 10/24/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 153654 | UNITED CONCORDIA | VA |
| 01 | — | 453709 | ANTHEM | VA |
| 05 | — | 5894 | — | VA |