Provider Demographics
NPI:1265450563
Name:ALOE, CARISSIMA ELLEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARISSIMA
Middle Name:ELLEN
Last Name:ALOE
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 1:102 S WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LUDINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49431-2283
Mailing Address - Country:US
Mailing Address - Phone:231-843-2751
Mailing Address - Fax:231-845-8336
Practice Address - Street 1:102 S WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:LUDINGTON
Practice Address - State:MI
Practice Address - Zip Code:49431-2283
Practice Address - Country:US
Practice Address - Phone:231-843-2751
Practice Address - Fax:231-845-8336
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010135861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice