Provider Demographics
NPI:1629154869
Name:LAUDANO, ANTHONY P (DMD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:P
Last Name:LAUDANO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:75 VAN DEENE AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089
Mailing Address - Country:US
Mailing Address - Phone:413-788-9621
Mailing Address - Fax:413-788-0103
Practice Address - Street 1:75 VAN DEENE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089
Practice Address - Country:US
Practice Address - Phone:413-788-9621
Practice Address - Fax:413-788-0103
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA216631223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery