Provider Demographics
NPI:1245349067
Name:CASELLI, DENNIS ALFRED (DDS)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:ALFRED
Last Name:CASELLI
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:PO BOX 330070
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94133-0070
Mailing Address - Country:US
Mailing Address - Phone:415-981-1465
Mailing Address - Fax:415-421-8318
Practice Address - Street 1:1606 STOCKTON ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94133-3300
Practice Address - Country:US
Practice Address - Phone:415-981-1465
Practice Address - Fax:415-421-8318
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA258701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice