Provider Demographics
NPI:1558515429
Name:ANTHONY A DIGIORNO DDS
Entity Type:Organization
Organization Name:ANTHONY A DIGIORNO DDS
Other - Org Name:DIGIORNO DENTAL FITNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:A
Authorized Official - Last Name:DIGIORNO
Authorized Official - Suffix:SR
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-817-6453
Mailing Address - Street 1:750 OAK AVENUE PKWY
Mailing Address - Street 2:STE. 190
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-6865
Mailing Address - Country:US
Mailing Address - Phone:916-817-6453
Mailing Address - Fax:916-817-6482
Practice Address - Street 1:750 OAK AVENUE PKWY
Practice Address - Street 2:STE. 190
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-6865
Practice Address - Country:US
Practice Address - Phone:916-817-6453
Practice Address - Fax:916-817-6482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-05
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21447122300000X
CA52849122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty