Healthcare Provider Details

I. General information

NPI: 1275752990
Provider Name (Legal Business Name): ANTHONY F DELIO D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 07/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 W CORTARO FARMS RD SUITE 101
TUCSON AZ
85742-8615
US

IV. Provider business mailing address

12265 N TALL GRASS DR
ORO VALLEY AZ
85755-8746
US

V. Phone/Fax

Practice location:
  • Phone: 520-572-4244
  • Fax:
Mailing address:
  • Phone: 520-572-4244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number6841
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberD04532
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: