Provider Demographics
NPI:1194827196
Name:FESTA, ANTHONY THOMAS (DDS)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:THOMAS
Last Name:FESTA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 TOMMYS LANE
Mailing Address - Street 2:
Mailing Address - City:WEST NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850
Mailing Address - Country:US
Mailing Address - Phone:203-866-4751
Mailing Address - Fax:203-966-5417
Practice Address - Street 1:116 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:NEW CANAAN
Practice Address - State:CT
Practice Address - Zip Code:06840
Practice Address - Country:US
Practice Address - Phone:203-966-9696
Practice Address - Fax:203-966-5417
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007694122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist