Provider Demographics
NPI:1104672419
Name:MICHAEL S. CALTABIANO DMD LLC
Entity type:Organization
Organization Name:MICHAEL S. CALTABIANO DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SMITH
Authorized Official - Last Name:CALTABIANO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-284-1395
Mailing Address - Street 1:659 EXTON CMNS
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2446
Mailing Address - Country:US
Mailing Address - Phone:610-363-6181
Mailing Address - Fax:
Practice Address - Street 1:659 EXTON CMNS
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2446
Practice Address - Country:US
Practice Address - Phone:610-363-6181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty