Provider Demographics
NPI:1699545111
Name:ANA & ANTHONY DENTAL LLC
Entity type:Organization
Organization Name:ANA & ANTHONY DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANA
Authorized Official - Middle Name:VALENTINA
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:407-342-5437
Mailing Address - Street 1:38530 LAKE SHORE BLVD
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-7163
Mailing Address - Country:US
Mailing Address - Phone:440-953-1733
Mailing Address - Fax:
Practice Address - Street 1:38530 LAKE SHORE BLVD
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-7163
Practice Address - Country:US
Practice Address - Phone:440-953-1733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental