Provider Demographics
NPI:1720171713
Name:ILARDO, ANTHONY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:ILARDO
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 1:27 BEERS RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06612-1721
Mailing Address - Country:US
Mailing Address - Phone:203-261-5809
Mailing Address - Fax:
Practice Address - Street 1:235 GLENVILLE RD
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-4148
Practice Address - Country:US
Practice Address - Phone:203-531-5595
Practice Address - Fax:203-531-5663
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004706122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist