Provider Demographics
NPI:1477667632
Name:GASSER, ANGELA R (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:R
Last Name:GASSER
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 1:1428 FIXLER RD
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-9226
Mailing Address - Country:US
Mailing Address - Phone:330-239-2239
Mailing Address - Fax:
Practice Address - Street 1:1219 HIGH ST
Practice Address - Street 2:STE 110
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-9421
Practice Address - Country:US
Practice Address - Phone:330-336-8478
Practice Address - Fax:330-336-0248
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH20918122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist