Provider Demographics
NPI:1497882542
Name:DELIBERATO, ANTHONY M (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:M
Last Name:DELIBERATO
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:24600 DETROIT ROAD
Mailing Address - Street 2:#200
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-2542
Mailing Address - Country:US
Mailing Address - Phone:440-808-9809
Mailing Address - Fax:440-808-9984
Practice Address - Street 1:24600 DETROIT ROAD
Practice Address - Street 2:#200
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-2542
Practice Address - Country:US
Practice Address - Phone:440-808-9809
Practice Address - Fax:440-808-9984
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH300177801223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics