Provider Demographics
NPI:1558519306
Name:DINARDO, ANTHONY DOMINICK (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:DOMINICK
Last Name:DINARDO
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 1:65 CONN BLVD
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108
Mailing Address - Country:US
Mailing Address - Phone:860-289-5423
Mailing Address - Fax:860-289-6795
Practice Address - Street 1:65 CONN BLVD
Practice Address - Street 2:
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06108
Practice Address - Country:US
Practice Address - Phone:860-289-5423
Practice Address - Fax:860-289-6795
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3612122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist