Organization
DONALD A FANTUZZO DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD ARDEN FANTUZZO DDS (OWNER DENTIST)
(765) 457-8359
Entity
Organization
Contact information
Practice address
2196 W SYCAMORE ST, KOKOMO, IN 46901
(765) 457-8359
(765) 457-9310
Mailing address
2196 W SYCAMORE ST, KOKOMO, IN 46901
(765) 457-8359
(765) 457-9310
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010681A
IN
Other
Enumeration date
09/01/2006
Last updated
08/22/2020
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