Provider Demographics
NPI:1205908415
Name:CASSARA, JOSEPH MARCO (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MARCO
Last Name:CASSARA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1057 EL MONTE AVENUE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040
Mailing Address - Country:US
Mailing Address - Phone:650-969-2866
Mailing Address - Fax:650-969-2887
Practice Address - Street 1:1057 EL MONTE AVENUE
Practice Address - Street 2:SUITE B
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040
Practice Address - Country:US
Practice Address - Phone:650-969-2866
Practice Address - Fax:650-969-2887
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA014321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice