Individual
DR. AUSTIN LUCAS CACCIAGLIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(888) 584-7888
Mailing address
2274 WINTER RIDGE DR, TRAVERSE CITY, MI 49686-8244
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
019032889
IL
Other
Enumeration date
09/30/2021
Last updated
05/24/2023
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