Provider Demographics
NPI:1528233400
Name:ROSSI, ANTHONY MARINO (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:MARINO
Last Name:ROSSI
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 1:119 GREENWICH ST
Mailing Address - Street 2:
Mailing Address - City:BELVIDERE
Mailing Address - State:NJ
Mailing Address - Zip Code:07823
Mailing Address - Country:US
Mailing Address - Phone:908-475-3838
Mailing Address - Fax:908-475-3639
Practice Address - Street 1:119 GREENWICH ST
Practice Address - Street 2:
Practice Address - City:BELVIDERE
Practice Address - State:NJ
Practice Address - Zip Code:07823
Practice Address - Country:US
Practice Address - Phone:908-475-3838
Practice Address - Fax:908-475-3639
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ118421223G0001X
PA117481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice