Provider Demographics
NPI:1114931821
Name:MONTELLA, ANTHONY JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JOSEPH
Last Name:MONTELLA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:696 HAMPSHIRE RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-2699
Mailing Address - Country:US
Mailing Address - Phone:805-494-3377
Mailing Address - Fax:805-494-3399
Practice Address - Street 1:696 HAMPSHIRE RD
Practice Address - Street 2:SUITE 160
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2699
Practice Address - Country:US
Practice Address - Phone:805-494-3377
Practice Address - Fax:805-494-3399
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL0190252511223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics