Lee Michael Ceresa is a Endodontics in Peru, Illinois. Lee Michael Ceresa practices all healthcare services and medical treatments related to Endodontics. The NPI Number for Lee Michael Ceresa is 1063513117. The last update date is 2014-09-30.
Lee Michael Ceresa's current location address is 1601 4th St, Peru, Illinois. You can contact this provider via phone number 8152243636 and fax number 8152201479. The mailing address for Lee Michael Ceresa is 1601 4th St, Peru, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Lee Michael Ceresa |
|---|---|
| Address | 1601 4th St, Peru, Illinois |
| Phone Number | 8152243636 |
| Fax Number | 8152201479 |
| Sole Proprietor | Y |
| Credentials | D.D.S. |
NPI Number Detail
| NPI Number | 1063513117 |
|---|---|
| Provider Enumeration Date | 2006-09-25 |
| Last Updated Date | 2014-09-30 |
Provider Mailing Address Detail
| Address | 1601 4th St |
|---|---|
| City | Peru |
| State | Illinois (IL) |
| Post Code | 613543507 |
| Phone Number | 8152243636 |
| Fax Number | 8152201479 |
Provider's Primary Taxonomy Detail
| Speciality | Endodontics |
|---|---|
| Taxonomy | 1223E0200X |
| Licence No | 21001935 |
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Definition: The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the eti |
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What is the unique provider identifier assigned to Lee Michael Ceresa?
The Lee Michael Ceresa has been issued the NPI (National Provider Identifier) 1063513117 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Where is the Lee Michael Ceresa located?
The Lee Michael Ceresa is located at 1601 4Th St, Peru, IL 613543507.
What is the area of specialization for Lee Michael Ceresa, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Lee Michael Ceresa is Endodontics, and the corresponding taxonomy code that categorizes this area of expertise is 1223E0200X.
When was the Lee Michael Ceresa's 1063513117 issued?
The Lee Michael Ceresa's 1063513117 was issued on 2006-09-25.
As of what date were the Lee Michael Ceresa's details last updated?
The information pertaining to the Lee Michael Ceresa, including its address, specialty, and other details, was most recently updated on 2014-09-30.