Provider Demographics
NPI:1861502015
Name:ANAPOLLE, ROSS LEE (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:LEE
Last Name:ANAPOLLE
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 1:980 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451
Mailing Address - Country:US
Mailing Address - Phone:781-899-2999
Mailing Address - Fax:781-647-9505
Practice Address - Street 1:980 MAIN ST
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451
Practice Address - Country:US
Practice Address - Phone:781-899-2999
Practice Address - Fax:781-647-9505
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2017-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA192101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice