MEDICARE: DR. FRANK CASANOVA D.D.S., M.SC.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	23714	CA

General Provider Information

NPI Number	:	1487657391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK CASANOVA D.D.S., M.SC.D.

Provider Business Mailing Address
First Line	:	2801 WATERMAN BLVD
Second Line	:	STE 290
City	:	FAIRFIELD
State	:	CA
Zip	:	94534-2972
Country	:	US
Telephone Number	:	707-425-5666
Fax Number	:	707-425-7046

Provider Business Practice Location Address
First Line	:	2801 WATERMAN BLVD
Second Line	:	STE 290
City	:	FAIRFIELD
State	:	CA
Zip	:	94534-2972
Country	:	US
Telephone Number	:	707-425-5666
Fax Number	:	707-425-7046

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. FRANK CASANOVA D.D.S., M.SC.D.” Practice Location

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