Provider Demographics
NPI:1184637647
Name:PASCALE, ANTHONY MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:MICHAEL
Last Name:PASCALE
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 1:3671 US HIGHWAY 9W
Mailing Address - Street 2:P.O. BOX 710
Mailing Address - City:HIGHLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12528-2000
Mailing Address - Country:US
Mailing Address - Phone:845-691-6499
Mailing Address - Fax:845-691-8939
Practice Address - Street 1:3671 US HIGHWAY 9W
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:NY
Practice Address - Zip Code:12528-2000
Practice Address - Country:US
Practice Address - Phone:845-691-6499
Practice Address - Fax:845-691-8939
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031761122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist