MEDICARE: DR. ANTHONY N. ALTIERI 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
1	1223G0001X	General Practice Dentistry	3409	ME

General Provider Information

NPI Number	:	1396771887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY N. ALTIERI D.M.D.

Provider Business Mailing Address
First Line	:	PO BOX 57
Second Line	:
City	:	KENNEBUNK
State	:	ME
Zip	:	04043-0057
Country	:	US
Telephone Number	:	207-985-3576
Fax Number	:	207-467-9125

Provider Business Practice Location Address
First Line	:	1220 PORTLAND RD
Second Line	:
City	:	ARUNDEL
State	:	ME
Zip	:	04046-8104
Country	:	US
Telephone Number	:	207-985-3576
Fax Number	:	207-467-9125

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2006
Last Update Date	:	07/08/2007

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