Provider Demographics
NPI:1861178808
Name:FRANCO, CASSANDRA G
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:G
Last Name:FRANCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4190 SW 90TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-5352
Mailing Address - Country:US
Mailing Address - Phone:305-335-7989
Mailing Address - Fax:
Practice Address - Street 1:900 HOOKS ST STE 100
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-3549
Practice Address - Country:US
Practice Address - Phone:352-360-7274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN29488122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist