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General NPI Number Information
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NPI Number | 1306574660
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Entity Type | Individual
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Provider Name | ARIELLE CASACLANG DMD
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Gender | Female
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Dates
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Enumeration Date | 08/12/2022
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Last Update Date | 08/12/2022
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Provider Practice Location Address
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Address Line | 495 N RIVERSIDE DR STE 204
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City | GURNEE
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State | IL
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Zip | 60031-5920
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Country | US
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Telephone | 847-336-8611
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Fax |
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Provider Business Mailing Address
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Address Line | 2328 S GOEBBERT RD APT 1092
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60005-5100
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Country | US
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Telephone | 847-980-3281
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 019.033820
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License Number State | IL
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