Individual
DR. JOSEPH CARL CECERE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2501 RIDGMAR PLZ, SUITE 108, FORT WORTH, TX 76116-2689
(817) 731-8629
(817) 732-0563
Mailing address
2501 RIDGMAR PLZ, SUITE 108, FORT WORTH, TX 76116-2689
(817) 731-8629
(817) 732-0563
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
14609
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0122878002
CIGNA
—
05
—
126649605
—
TX
01
—
4104349
AETNA
TX
01
—
75159423576086A002
TRICARE
—
01
—
792590
UNITED CONCORDIA DENTAL
—
01
—
83M212
BCBS
TX
Enumeration date
06/05/2006
Last updated
04/25/2016
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