Provider Demographics
NPI:1619066958
Name:MAGNER, ANNE (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:
Last Name:MAGNER
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 E 48TH ST
Mailing Address - Street 2:1602
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-1014
Mailing Address - Country:US
Mailing Address - Phone:212-223-3800
Mailing Address - Fax:212-223-3802
Practice Address - Street 1:18 E 48TH ST
Practice Address - Street 2:1602
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-1014
Practice Address - Country:US
Practice Address - Phone:212-223-3800
Practice Address - Fax:212-223-3802
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY351891223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY35189OtherSTATE ID NUMBER