Individual
DR. GERALD H KASSOY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
1418 BRICE RD, REYNOLDSBURG, OH 43068-2397
(614) 575-2225
(614) 575-2252
Mailing address
377 S ROOSEVELT AVE, BEXLEY, OH 43209-1831
(614) 235-9931
(614) 575-2252
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
14900
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0398627
—
OH
01
—
310961704-026
CARESOURCE
OH
Enumeration date
05/13/2006
Last updated
07/08/2007
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