Provider Demographics
NPI:1790896017
Name:MASCIA, ANTHONY F (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:F
Last Name:MASCIA
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 1:803 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-6519
Mailing Address - Country:US
Mailing Address - Phone:732-349-1626
Mailing Address - Fax:732-286-0788
Practice Address - Street 1:803 MAIN ST
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-6519
Practice Address - Country:US
Practice Address - Phone:732-349-1626
Practice Address - Fax:732-286-0788
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1008920001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice