Provider Demographics
NPI:1396118824
Name:ANCHOR DENTAL
Entity type:Organization
Organization Name:ANCHOR DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CATALLOZZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-846-4404
Mailing Address - Street 1:37 LONG WHARF MALL
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-2906
Mailing Address - Country:US
Mailing Address - Phone:401-846-4404
Mailing Address - Fax:
Practice Address - Street 1:37 LONG WHARF MALL
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-2906
Practice Address - Country:US
Practice Address - Phone:401-846-4404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN031561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty