Provider Demographics
NPI:1740380690
Name:ANTHONY M. FRATANTONIO DDS, INC.
Entity Type:Organization
Organization Name:ANTHONY M. FRATANTONIO DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:FRATANTONIO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:330-655-8919
Mailing Address - Street 1:9 AURORA STREET SUITE #1
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236
Mailing Address - Country:US
Mailing Address - Phone:330-655-8919
Mailing Address - Fax:330-528-3625
Practice Address - Street 1:9 AURORA STREET SUITE #1
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236
Practice Address - Country:US
Practice Address - Phone:330-655-8919
Practice Address - Fax:330-528-3625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH206751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty