Provider Demographics
NPI:1275688095
Name:GACITA, ANTHONY MARSHALL (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:MARSHALL
Last Name:GACITA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 MORGAN DR
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-2418
Mailing Address - Country:US
Mailing Address - Phone:215-628-0191
Mailing Address - Fax:215-628-0191
Practice Address - Street 1:1450 CLEMENTS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-3067
Practice Address - Country:US
Practice Address - Phone:856-845-3046
Practice Address - Fax:856-853-9155
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ018398122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist