Provider Demographics
NPI:1245285568
Name:CASALENA, HERBERT THOMAS (DDS)
Entity type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:THOMAS
Last Name:CASALENA
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 1:2300 PENNSYLVANIA AVE
Mailing Address - Street 2:6TH FLOOR, SUITE A&B
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-1392
Mailing Address - Country:US
Mailing Address - Phone:302-984-3300
Mailing Address - Fax:302-984-3303
Practice Address - Street 1:2300 PENNSYLVANIA AVE
Practice Address - Street 2:6TH FLOOR, SUITE A&B
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-1392
Practice Address - Country:US
Practice Address - Phone:302-984-3300
Practice Address - Fax:302-984-3303
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-00006781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice