Organization
JOSEPH CERAVOLO DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH CERAVOLO DDS (CEO)
(310) 990-1636
Entity
Organization
Contact information
Practice address
1304 15TH ST, STE 314, SANTA MONICA, CA 90404-1809
(310) 394-5879
Mailing address
322 CULVER BLVD, STE #274, PLAYA DEL REY, CA 90293-7704
(310) 990-1636
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
48513
CA
Other
Enumeration date
03/06/2008
Last updated
03/06/2008
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