| Cassis Dental Center, Pllc | |
|
138 Lively St Fayetteville WV 25840-1148 | |
| (304) 574-0424 | |
| (304) 574-2102 |
| Full Name | Cassis Dental Center, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 138 Lively St, Fayetteville, West Virginia |
| Authorized Official Name and Position | Bruce L Cassis (OWNER / DENTIST) |
| Authorized Official Contact | 3045740424 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cassis Dental Center, Pllc 138 Lively St Fayetteville WV 25840-1148 Ph: (304) 574-0424 | Cassis Dental Center, Pllc 138 Lively St Fayetteville WV 25840-1148 Ph: (304) 574-0424 |
| NPI Number | 1619339207 |
|---|---|
| Provider Enumeration Date | 03/23/2016 |
| Last Update Date | 12/07/2022 |
| Medicare PECOS PAC ID | 3678867637 |
|---|---|
| Medicare Enrollment ID | O20200303001979 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619339207 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Bruce L Cassis |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1679664510 PECOS PAC ID: 2062643513 Enrollment ID: I20141120001277 |
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 | |
Bruce L. Cassis Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 138 Lively St, Fayetteville, WV 25840 Phone: 304-574-0424 Fax: 304-574-2102 |