Provider Demographics
NPI:1417020140
Name:CHICOLA, ANTHONY EMILE (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:EMILE
Last Name:CHICOLA
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 1:5075 CARPENTER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2521
Mailing Address - Country:US
Mailing Address - Phone:850-477-7604
Mailing Address - Fax:850-477-7604
Practice Address - Street 1:5075 CARPENTER CREEK DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2521
Practice Address - Country:US
Practice Address - Phone:850-477-8482
Practice Address - Fax:850-477-7604
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL166831223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery