Provider Demographics
NPI:1538297056
Name:TRENTACOSTE, ANTHONY JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:TRENTACOSTE
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N CAUSEWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-5348
Mailing Address - Country:US
Mailing Address - Phone:504-835-8741
Mailing Address - Fax:504-834-3167
Practice Address - Street 1:900 N CAUSEWAY BLVD
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-5348
Practice Address - Country:US
Practice Address - Phone:504-835-8741
Practice Address - Fax:504-834-3167
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA34791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice