Organization
FRANK J CERCONE, DMD, APC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHRYN L LOUGEE (FINANCE/INSURANCE)
(707) 522-1059
Entity
Organization
Contact information
Practice address
1880 SONOMA AVE, SANTA ROSA, CA 95405-4953
(707) 542-1644
(707) 546-0166
Mailing address
1880 SONOMA AVE, SANTA ROSA, CA 95405-4953
(707) 542-1644
(707) 546-0166
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
23921
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G93119
DENTI-CAL
CA
Enumeration date
10/08/2012
Last updated
10/08/2012
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