Provider Demographics
NPI:1629025937
Name:MONTELEONE, ANTHONY L II (DMD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:L
Last Name:MONTELEONE
Suffix:II
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 1:926 GREAT POND DR
Mailing Address - Street 2:SUITE 2003
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-7244
Mailing Address - Country:US
Mailing Address - Phone:407-772-5124
Mailing Address - Fax:407-788-3572
Practice Address - Street 1:1724 MOUNT ROYAL BLVD
Practice Address - Street 2:
Practice Address - City:GLENSHAW
Practice Address - State:PA
Practice Address - Zip Code:15116-2115
Practice Address - Country:US
Practice Address - Phone:412-213-1999
Practice Address - Fax:412-213-6985
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0248101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018952450003Medicaid
PA0018952450005Medicaid
PA0018952450011Medicaid
PA0018952450002Medicaid
PA0018952450010Medicaid
PA0018952450013Medicaid
PA0018952450014Medicaid
PA0018952450004Medicaid
PA0018952450009Medicaid
PA0018952450012Medicaid
PA0018952450007Medicaid
PA0018952450008Medicaid
PA0018952450006Medicaid