| Donald A Fantuzzo Dds Pc | |
|
2196 W Sycamore St Kokomo IN 46901 | |
| (765) 457-8359 | |
| (765) 457-9310 |
| Full Name | Donald A Fantuzzo Dds Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2196 W Sycamore St, Kokomo, Indiana |
| Authorized Official Name and Position | Donald Arden Fantuzzo (OWNER DENTIST) |
| Authorized Official Contact | 7654578359 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Donald A Fantuzzo Dds Pc 2196 W Sycamore St Kokomo IN 46901 Ph: (765) 457-8359 | Donald A Fantuzzo Dds Pc 2196 W Sycamore St Kokomo IN 46901 Ph: (765) 457-8359 |
| NPI Number | 1740382928 |
|---|---|
| Provider Enumeration Date | 09/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740382928 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12010681A (Indiana) | Primary |
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