Provider Demographics
NPI:1336523141
Name:RAPOZA, ANTHONY JEFFREY (DMD)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:JEFFREY
Last Name:RAPOZA
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 1:1319 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:PROSPECT PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19076-1216
Mailing Address - Country:US
Mailing Address - Phone:610-532-5008
Mailing Address - Fax:610-532-2459
Practice Address - Street 1:1319 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:PROSPECT PARK
Practice Address - State:PA
Practice Address - Zip Code:19076-1216
Practice Address - Country:US
Practice Address - Phone:610-532-5008
Practice Address - Fax:610-532-2459
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025682L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice