Individual
DONALD A FANTUZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1690 S OHIO ST, MARTINSVILLE, IN 46151-3317
(765) 342-8435
(765) 457-9310
Mailing address
6414 LITTLE FLOCK RD, SPENCER, IN 47460-5889
(812) 876-4179
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010681A
IN
Other
Enumeration date
09/01/2006
Last updated
07/11/2019
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