Provider Demographics
NPI:1992852669
Name:CONCEPCION, ANTHONY F (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:F
Last Name:CONCEPCION
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 W DUARTE RD STE 403
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-9235
Mailing Address - Country:US
Mailing Address - Phone:626-446-9944
Mailing Address - Fax:626-446-5202
Practice Address - Street 1:612 W DUARTE RD STE 403
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-9235
Practice Address - Country:US
Practice Address - Phone:626-446-9944
Practice Address - Fax:626-446-5202
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA495011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice