Organization
DONALD FANTUZZO, DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD A FANTUZZO DDS (OWNER/DENTIST)
(812) 876-4179
Entity
Organization
Contact information
Practice address
1690 S OHIO ST, MARTINSVILLE, IN 46151-3317
(765) 352-8435
Mailing address
6414 LITTLE FLOCK RD, SPENCER, IN 47460-5889
(812) 876-4179
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/11/2019
Last updated
07/11/2019
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