Provider Demographics
NPI:1225139215
Name:CARDOZA, ANTHONY RICARDO (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:RICARDO
Last Name:CARDOZA
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 1:266 AVOCADO AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-4670
Mailing Address - Country:US
Mailing Address - Phone:619-444-6196
Mailing Address - Fax:619-444-6037
Practice Address - Street 1:266 AVOCADO AVE
Practice Address - Street 2:SUITE B
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-4670
Practice Address - Country:US
Practice Address - Phone:619-444-6196
Practice Address - Fax:619-444-6037
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice