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ALBERT ANSELMO CACCIVIO DENTURIST

Dental Providers Denturist

Provider NPI: 1033462155

Provider Information:
 ALBERT ANSELMO CACCIVIO DENTURIST
Gender: M
Not Sole Proprietor

Practice Location:
905 RIVER RD  EUGENE, OR 97404-3228 US
Tel: 541-461-2020  Fax: --

Business Mailing Address:
905 RIVER RD  EUGENE, OR 97404-3228 US
Tel: 541-461-2020  Fax: --

NPI Information:
NPI: 1033462155
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122400000XDental Providers
Denturist
ORDT-DO-461580

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 122400000X

Type:

Classification:



Definition:



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