Provider Demographics
NPI:1902646573
Name:GEORGE P CERNIGLIA A PROFESSIONAL DENTAL CORPORATION
Entity type:Organization
Organization Name:GEORGE P CERNIGLIA A PROFESSIONAL DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:P
Authorized Official - Last Name:CERNIGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:504-454-5880
Mailing Address - Street 1:3320 HESSMER AVE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-4727
Mailing Address - Country:US
Mailing Address - Phone:504-454-5880
Mailing Address - Fax:504-454-8332
Practice Address - Street 1:3320 HESSMER AVE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-4727
Practice Address - Country:US
Practice Address - Phone:504-454-5880
Practice Address - Fax:504-454-8332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental