Provider Demographics
NPI:1124884127
Name:CASE, ALYSSA J (DDS)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:J
Last Name:CASE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:391 NORTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47006-7012
Mailing Address - Country:US
Mailing Address - Phone:812-934-3651
Mailing Address - Fax:
Practice Address - Street 1:391 NORTHSIDE DR
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006-7012
Practice Address - Country:US
Practice Address - Phone:812-934-3651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-27
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12014447A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist