Provider Demographics
NPI:1720151772
Name:BADDOO, ANTHONY P (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:P
Last Name:BADDOO
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 1:4500 WILLIAM PENN HWY
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-4845
Mailing Address - Country:US
Mailing Address - Phone:610-923-8340
Mailing Address - Fax:610-923-8342
Practice Address - Street 1:4500 WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-4845
Practice Address - Country:US
Practice Address - Phone:610-923-8340
Practice Address - Fax:610-923-8342
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030521L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice