Provider Demographics
NPI:1750369823
Name:JAMES E. LOCASCIO, D.D.S.P.C.
Entity type:Organization
Organization Name:JAMES E. LOCASCIO, D.D.S.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:LOCASCIO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-682-4003
Mailing Address - Street 1:4189 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-2136
Mailing Address - Country:US
Mailing Address - Phone:248-682-4003
Mailing Address - Fax:248-682-6352
Practice Address - Street 1:4189 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-2136
Practice Address - Country:US
Practice Address - Phone:248-682-4003
Practice Address - Fax:248-682-6352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901013027122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty