Provider Demographics
NPI:1477524445
Name:BRUSCA, ANTHONY M JR (DMD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:M
Last Name:BRUSCA
Suffix:JR
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 1:4407 OLD WILLIAM PENN HWY
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668-1940
Mailing Address - Country:US
Mailing Address - Phone:724-325-2232
Mailing Address - Fax:724-325-2259
Practice Address - Street 1:4407 OLD WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-1940
Practice Address - Country:US
Practice Address - Phone:724-325-2232
Practice Address - Fax:724-325-2259
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020720L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist