Individual
DR. ALFRED JOSEPH CERTOSIMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
520 N 12TH ST, P.O. 980566, RICHMOND, VA 23298-5064
(804) 828-9190
(804) 828-9358
Mailing address
520 N 12TH ST, P.O. 980566, RICHMOND, VA 23298-5064
(804) 828-9190
(804) 828-9358
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401008264
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
153654
UNITED CONCORDIA
VA
01
—
453709
ANTHEM
VA
05
—
5894
—
VA
Enumeration date
10/24/2008
Last updated
10/24/2008
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