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General NPI Number Information
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NPI Number | 1295951861
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Entity Type | Organization
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Legal Business Name | ANGELA R. GASSER DDS LLC
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1219 HIGH ST SUITE110
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City | WADSWORTH
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State | OH
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Zip | 44281-9421
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Country | US
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Telephone | 330-336-8478
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Fax | 330-336-0248
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Provider Business Mailing Address
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Address Line | 1219 HIGH ST SUITE110
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City | WADSWORTH
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State | OH
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Zip | 44281-9421
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Country | US
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Telephone | 330-336-8478
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Fax | 330-336-0248
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANGELA RAE GASSER
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Credential | DDS
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Telephone | 330-336-8478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 20918
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License Number State | OH
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