Provider Demographics
NPI:1770604795
Name:VILARDI, MARIO ANTHONY (DMD)
Entity type:Individual
Prefix:DR
First Name:MARIO
Middle Name:ANTHONY
Last Name:VILARDI
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 1:887 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-2254
Mailing Address - Country:US
Mailing Address - Phone:845-896-8000
Mailing Address - Fax:845-897-2504
Practice Address - Street 1:887 MAIN ST
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-2254
Practice Address - Country:US
Practice Address - Phone:845-896-8000
Practice Address - Fax:845-897-2504
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0326871223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics