Provider Demographics
NPI:1194051045
Name:ANOIA, TAMIKA K (DDS)
Entity type:Individual
Prefix:DR
First Name:TAMIKA
Middle Name:K
Last Name:ANOIA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4382
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-0382
Mailing Address - Country:US
Mailing Address - Phone:518-798-9561
Mailing Address - Fax:
Practice Address - Street 1:1ST ADVANTAGE DENTAL
Practice Address - Street 2:1092 RTE 9
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-0382
Practice Address - Country:US
Practice Address - Phone:518-798-9561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY546301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice