Provider Demographics
NPI:1871799767
Name:D.DOUGLAS CASSAT, DDS.APC
Entity type:Organization
Organization Name:D.DOUGLAS CASSAT, DDS.APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:CASSAT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:858-565-0212
Mailing Address - Street 1:10789 TIERRASANTA BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92124-2613
Mailing Address - Country:US
Mailing Address - Phone:858-565-0212
Mailing Address - Fax:
Practice Address - Street 1:10789 TIERRASANTA BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92124-2613
Practice Address - Country:US
Practice Address - Phone:858-565-0212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty