Provider Demographics
NPI:1386852507
Name:ANTHONY M. STORACE, DMD, PLLC
Entity Type:Organization
Organization Name:ANTHONY M. STORACE, DMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:M
Authorized Official - Last Name:STORACE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MAGD
Authorized Official - Phone:603-880-3496
Mailing Address - Street 1:20 MERRIT PARKWAY
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-3029
Mailing Address - Country:US
Mailing Address - Phone:603-880-3496
Mailing Address - Fax:
Practice Address - Street 1:20 MERRIT PKWY
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-3029
Practice Address - Country:US
Practice Address - Phone:603-880-3496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-20
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH16461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty