Provider Demographics
NPI:1790990281
Name:CALANDRA, ANTHONY J JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:J
Last Name:CALANDRA
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 HERITAGE VALLEY DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-1752
Mailing Address - Country:US
Mailing Address - Phone:856-582-5555
Mailing Address - Fax:856-582-7556
Practice Address - Street 1:100 HERITAGE VALLEY DRIVE
Practice Address - Street 2:SUITE 3
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-1752
Practice Address - Country:US
Practice Address - Phone:856-582-5555
Practice Address - Fax:856-582-7556
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI017007001223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral Practice