| Bruce L. Cassis | |
|
138 Lively St Fayetteville WV 25840-1148 | |
| (304) 574-0424 | |
| (304) 574-2102 |
| Full Name | Bruce L. Cassis |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 138 Lively St, Fayetteville, West Virginia |
| Authorized Official Name and Position | Bruce L Cassis (OWNER) |
| Authorized Official Contact | 3045740424 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bruce L. Cassis 138 Lively St P. O. Box 926 Fayetteville WV 25840-1148 Ph: (304) 574-0424 | Bruce L. Cassis 138 Lively St Fayetteville WV 25840-1148 Ph: (304) 574-0424 |
| NPI Number | 1275718710 |
|---|---|
| Provider Enumeration Date | 01/03/2008 |
| Last Update Date | 01/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275718710 | NPI | - | NPPES |
| 3810007224 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Patrick Jarrell Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 213 W Maple Ave, Fayetteville, WV 25840 Phone: 304-574-2833 Fax: 304-574-2489 | |
Cassis Dental Center, Pllc Dental Clinic Medicare: Medicare Enrolled Practice Location: 138 Lively St, Fayetteville, WV 25840 Phone: 304-574-0424 Fax: 304-574-2102 |