Provider Demographics
NPI:1033236807
Name:SANTARE, ANTHONY MICHAEL III (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:MICHAEL
Last Name:SANTARE
Suffix:III
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 1:35 LONESOME PINE RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-4723
Mailing Address - Country:US
Mailing Address - Phone:401-334-4436
Mailing Address - Fax:
Practice Address - Street 1:2300 DIAMOND HILL RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-4728
Practice Address - Country:US
Practice Address - Phone:401-334-4436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI21291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI8192-4OtherBC OF RI NPROVIDER #
RIAS12041Medicaid
RI2129OtherRI DELTA PROVIDER #
RI40-00292OtherUHP PROVIDER #
RIXROLLOOtherBC OF MASS PROVIDER