Provider Demographics
NPI:1366157471
Name:ANTHONY J CALANDRA JR D M D LLC
Entity type:Organization
Organization Name:ANTHONY J CALANDRA JR D M D LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CALANDRA
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:856-582-5555
Mailing Address - Street 1:100 HERITAGE VALLEY DR STE 3
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-1752
Mailing Address - Country:US
Mailing Address - Phone:856-582-5555
Mailing Address - Fax:856-582-7556
Practice Address - Street 1:100 HERITAGE VALLEY DR STE 3
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-1752
Practice Address - Country:US
Practice Address - Phone:856-582-5555
Practice Address - Fax:856-582-7556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty