Provider Demographics
NPI:1326377300
Name:DANA M. CASAUS, DDS, MS, PC
Entity type:Organization
Organization Name:DANA M. CASAUS, DDS, MS, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CASAUS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:505-508-4939
Mailing Address - Street 1:5910 CUBERO DR NE
Mailing Address - Street 2:SUITE D
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-3842
Mailing Address - Country:US
Mailing Address - Phone:505-508-4939
Mailing Address - Fax:505-717-1218
Practice Address - Street 1:5910 CUBERO DR NE
Practice Address - Street 2:SUITE D
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3842
Practice Address - Country:US
Practice Address - Phone:505-508-4939
Practice Address - Fax:505-717-1218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-21
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD31131223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty