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General NPI Number Information
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NPI Number | 1396905550
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Entity Type | Organization
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Legal Business Name | CLIFFORD L. ANZILOTTI, D.M.D., P.A.
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Dates
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Enumeration Date | 06/11/2008
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Last Update Date | 06/11/2008
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Provider Practice Location Address
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Address Line | 2101 FOULK RD
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City | WILMINGTON
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State | DE
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Zip | 19810-4710
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Country | US
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Telephone | 302-475-2050
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Fax |
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Provider Business Mailing Address
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Address Line | 2101 FOULK RD
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City | WILMINGTON
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State | DE
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Zip | 19810-4710
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Country | US
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Telephone | 302-475-2050
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CLIFFORD L. ANZILOTTI JR.
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Credential | D.M.D.
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Telephone | 302-475-2050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 1990015088
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License Number State | DE
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