Provider Demographics
NPI:1245385061
Name:CASSAR, ANGELA GRACE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:GRACE
Last Name:CASSAR
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 1:410 MAGNOLIA BRANCH DR
Mailing Address - Street 2:APT 7
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27104-4496
Mailing Address - Country:US
Mailing Address - Phone:336-201-2935
Mailing Address - Fax:
Practice Address - Street 1:100 WESTWOOD AVE
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-4317
Practice Address - Country:US
Practice Address - Phone:336-885-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8088122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist