Organization
RALPH A, CIASULLO DMD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RALPH A CIASULLO DMD (DENTIST)
(941) 795-4040
Entity
Organization
Contact information
Practice address
6220 MANATEE AVE W, SUITE 304, BRADENTON, FL 34209-2376
(941) 795-4040
(941) 794-8139
Mailing address
6220 MANATEE AVE W, SUITE 304, BRADENTON, FL 34209-2376
(941) 795-4040
(941) 794-8139
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
9834
FL
Other
Enumeration date
05/22/2012
Last updated
05/22/2012
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