Provider Demographics
NPI:1396970984
Name:SPINELLI, ANTHONY J (DDS)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:J
Last Name:SPINELLI
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 1:1307 N 43RD ST
Mailing Address - Street 2:APT. 408
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-7566
Mailing Address - Country:US
Mailing Address - Phone:914-843-7376
Mailing Address - Fax:
Practice Address - Street 1:105 W HARTSDALE AVE
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1618
Practice Address - Country:US
Practice Address - Phone:914-843-7376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-26
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0516871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice