Scba Casaclang DDS Ltd

NPI #1205055001 in Gyrnee, Illinois

Provider Information

NPI Number: 1205055001
Entity Type: Organization
Organization Name: Scba Casaclang DDS Ltd
Primary Specialty: Dentist
Enumeration Date: Apr 24, 2007
Last Updated: Jan 18, 2012

Practice Location

Address: 495 N RIVERSIDE DR STE 204
City: Gyrnee
State: Illinois
ZIP Code: 60031
Phone: (847) 336-8611

Authorized Official

Name: DR. CYNTHIA BALDOVINO CASACLANG, DDS
Title: PRESIDENT
Phone: (847) 336-8611

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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