Icasiano, Michelle
Icasiano, Michelle is an sole proprietor health care provider with primary practice located at 7101 Hoff St. Bldg 9240 Usa Dental Activity, Fort Benning GA 31905. She recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as her primary health care specialty. Icasiano, Michelle can be contacted via phone (706) 544-4530.Contact Information
Primary practice address
7101 Hoff St. Bldg 9240 Usa Dental Activity
Fort Benning GA 31905
Phone: (706) 544-4530
Fax: (706) 544-1933
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | DS029194L | Pennsylvania |
Profile Details
| NPI number | 1083700793 |
|---|---|
| LBN Legal business name | Icasiano, Michelle |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 4th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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