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NPI Code Detail

MEDICARE: CLIFFORD L ANZILOTTI JR. D.M.D.

MEDICARE: CLIFFORD L ANZILOTTI JR. D.M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry1990015088DE

General Provider Information

NPI Number : 1144316209
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLIFFORD L ANZILOTTI JR. D.M.D.
Provider Business Mailing Address
First Line : 2101 FOULK RD
Second Line :
City : WILMINGTON
State : DE
Zip : 19810-4710
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2101 FOULK RD
Second Line :
City : WILMINGTON
State : DE
Zip : 19810-4710
Country : US
Telephone Number : 302-475-2050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 04/21/2022

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