Provider Demographics
NPI:1437357993
Name:ANTHONY, DAVID C (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:ANTHONY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 TIPPETT CT
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SUNBURY
Mailing Address - State:OH
Mailing Address - Zip Code:43074-8572
Mailing Address - Country:US
Mailing Address - Phone:740-965-4090
Mailing Address - Fax:
Practice Address - Street 1:100 TIPPETT CT
Practice Address - Street 2:SUITE 103
Practice Address - City:SUNBURY
Practice Address - State:OH
Practice Address - Zip Code:43074-8572
Practice Address - Country:US
Practice Address - Phone:740-965-4090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-022542122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist