Provider Demographics
NPI:1841411279
Name:CASCINO, SUSAN ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:ANN
Last Name:CASCINO
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 1:1816 BAY SCOTT CIR STE 104
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-1113
Mailing Address - Country:US
Mailing Address - Phone:630-355-5010
Mailing Address - Fax:630-355-4317
Practice Address - Street 1:1816 BAY SCOTT CIR STE 104
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-1113
Practice Address - Country:US
Practice Address - Phone:630-355-5010
Practice Address - Fax:630-355-4317
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190220691223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics