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General NPI Number Information
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NPI Number | 1457558454
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Entity Type | Organization
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Legal Business Name | ANTHONY D'ADDARIO, DDS, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 28202 CABOT RD SUITE 460
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-1222
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Country | US
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Telephone | 949-364-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 28202 CABOT RD SUITE 460
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-1222
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Country | US
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Telephone | 949-364-5300
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANTHONY JOSEPH D'ADDARIO
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Credential | DDS
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Telephone | 949-364-5300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 31595
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License Number State | CA
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