Dante J Grasso, DMD
Individual provider Active NPI General Practice Dentistry · Boonville, IN
NPI 1235617622 · NPPES record last updated Jul 30, 2018
Key facts
- NPI
- 1235617622
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 12013015A (IN)
- Practice address
- 602 W. Locust St.
Boonville, IN 47601 - Phone
- (812) 897-3470
- Fax
- (812) 897-0068
- NPI assigned
- Jul 30, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12013015A | IN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kolb & Kolb DDS LLC | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12013015A | IN | Yes |
Addresses
Primary practice location
602 W. Locust St.
Boonville, IN 47601
Mailing address
PO Box 167
Boonville, IN 47601-0167
Phone (812) 897-3470
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 753139523 | Other | IN | DELTA DENTAL |
| 753139523 | Other | DENTAQUEST | |
| 753139523 | Other | IN | DENTAL HEALTH AND WELLNESS |
| 753139523 | Other | IN | HEALTH RESOURCES, INC |
| 753139523 | Other | IN | ANTHEM |
| 753139523 | Medicaid | IN | |
| 753139523 | Other | IN | UNITED CONCORDIA |
Other providers in Boonville, IN
- James P Given
- Ashley Goelzhauser
- Shaina Marie Gogel
- Good Samaritan Hospital
- Cathy Jean Gourley
- Amanda Grothouse
- Kaitlyn Nicole Halbig
- Cheryl L Hanou
- Charles Mitchell Hayman
- Cynthia Marie Hinds
All providers in Boonville, IN · General Practice Dentistry in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.