Provider Demographics
NPI:1396771887
Name:ALTIERI, ANTHONY N (DMD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:N
Last Name:ALTIERI
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:PO BOX 57
Mailing Address - Street 2:
Mailing Address - City:KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04043-0057
Mailing Address - Country:US
Mailing Address - Phone:207-985-3576
Mailing Address - Fax:207-467-9125
Practice Address - Street 1:1220 PORTLAND RD
Practice Address - Street 2:
Practice Address - City:ARUNDEL
Practice Address - State:ME
Practice Address - Zip Code:04046-8104
Practice Address - Country:US
Practice Address - Phone:207-985-3576
Practice Address - Fax:207-467-9125
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME34091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice