Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MICHELLE ICASIANO
Active Sole ProprietorMICHELLE ICASIANO is a Oral & Maxillofacial Surgery healthcare provider located in FORT BENNING, Georgia. NPI 1083700793 is currently active in the NPPES registry. Verify at CMS.
Oral & Maxillofacial Surgery · FORT BENNING, GA
Registration Details
- NPI Number
- 1083700793
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 4, 2006 (19.864459565511 yrs)
- Last Updated
- Jul 8, 2007
- License
-
DS029194L (PA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
7101 HOFF ST. BLDG 9240USA DENTAL ACTIVITYFORT BENNING, GA, 31905Browse GA providers · Browse ZIP 31905
- Phone
- 7065444530
- Fax
- 7065441933
- Primary Specialty
-
Oral & Maxillofacial Surgery
1223S0112X
Other Oral & Maxillofacial Surgery Providers in FORT BENNING, GA
| Name | Credential | NPI |
|---|---|---|
| DR. AUJIN KIM | DMD | 1477987378 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.