Provider Demographics
NPI:1609028570
Name:ANU ISAAC
Entity Type:Organization
Organization Name:ANU ISAAC
Other - Org Name:CORAL DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANU
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAAC
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-536-7007
Mailing Address - Street 1:6 POND VIEW RD
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-3637
Mailing Address - Country:US
Mailing Address - Phone:978-536-7007
Mailing Address - Fax:978-222-8461
Practice Address - Street 1:8 TRADERS WAY
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-1866
Practice Address - Country:US
Practice Address - Phone:978-536-7007
Practice Address - Fax:978-222-8461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAA203471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty