Provider Demographics
NPI:1215148036
Name:CASELLA, FRANK J (DDS)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:J
Last Name:CASELLA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 ALHAMBRA CIR
Mailing Address - Street 2:SUITE 134
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4524
Mailing Address - Country:US
Mailing Address - Phone:305-461-0255
Mailing Address - Fax:
Practice Address - Street 1:147 ALHAMBRA CIR
Practice Address - Street 2:SUITE 134
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4524
Practice Address - Country:US
Practice Address - Phone:305-461-0255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 13220122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist