Organization
MICHAEL B GASKO,DDS ,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL B GASKO DDS (PRESIDENT)
(574) 234-6561
Entity
Organization
Contact information
Practice address
225 N NOTRE DAME AVE, 5, SOUTH BEND, IN 46617-2839
(574) 234-6561
(574) 286-5144
Mailing address
225 N NOTRE DAME AVE, 5, SOUTH BEND, IN 46617-2839
(574) 234-6561
(574) 286-5144
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12007239IN
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200106530A
—
IN
Enumeration date
08/20/2015
Last updated
08/20/2015
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