Provider Demographics
NPI:1720199805
Name:MILANO, CARL JOSEPH (DMD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:JOSEPH
Last Name:MILANO
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 1:1412 SULLIVAN TRL
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040
Mailing Address - Country:US
Mailing Address - Phone:610-258-9081
Mailing Address - Fax:610-258-0377
Practice Address - Street 1:1412 SULLIVAN TRL
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18040
Practice Address - Country:US
Practice Address - Phone:610-258-9081
Practice Address - Fax:610-258-0377
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01160800204E00000X
PADS020803L204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
083705OtherHIGHMARK
051397OtherAETNA
083705OtherUNITED CONCORDIA DENTAL
50003547OtherCAPITOL BC MEDICAL
50003548OtherCAPITOL BC GROUP
50003548OtherCAPITOL BC GROUP