Provider Demographics
NPI:1275681330
Name:GASSMANN, CARL J (MD, DDS)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:J
Last Name:GASSMANN
Suffix:
Gender:M
Credentials:MD, DDS
Other - Prefix:
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Mailing Address - Street 1:10603 N HAYDEN RD
Mailing Address - Street 2:SUITE H-112
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-5518
Mailing Address - Country:US
Mailing Address - Phone:480-922-9933
Mailing Address - Fax:480-607-9120
Practice Address - Street 1:10603 N HAYDEN RD
Practice Address - Street 2:SUITE H-112
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-5518
Practice Address - Country:US
Practice Address - Phone:480-922-9933
Practice Address - Fax:480-607-9120
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZD48681223S0112X
AZ23387204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Not Answered204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery