Provider Demographics
NPI:1447379326
Name:CHILLURA, ANTHONY ERNEST (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:ERNEST
Last Name:CHILLURA
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 1:67 WALL ST
Mailing Address - Street 2:SUITE 2508
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10005-3101
Mailing Address - Country:US
Mailing Address - Phone:212-344-9317
Mailing Address - Fax:212-344-6973
Practice Address - Street 1:67 WALL ST
Practice Address - Street 2:SUITE 2508
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10005-3101
Practice Address - Country:US
Practice Address - Phone:212-344-9317
Practice Address - Fax:212-344-6973
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032188122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist