Provider Demographics
NPI:1588495352
Name:DINO A CACCHIOTTI DDS PLLC
Entity type:Organization
Organization Name:DINO A CACCHIOTTI DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DINO
Authorized Official - Middle Name:
Authorized Official - Last Name:CACCHIOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:509-766-2833
Mailing Address - Street 1:961 E NELSON RD
Mailing Address - Street 2:
Mailing Address - City:MOSES LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98837-4710
Mailing Address - Country:US
Mailing Address - Phone:509-766-2833
Mailing Address - Fax:
Practice Address - Street 1:961 E NELSON RD
Practice Address - Street 2:
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837-4710
Practice Address - Country:US
Practice Address - Phone:509-766-2833
Practice Address - Fax:509-766-2028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty