Provider Demographics
NPI:1447361753
Name:ANTHONY, JOSEPH EFREM (DDS,MS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:EFREM
Last Name:ANTHONY
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 S GLENDORA AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-6210
Mailing Address - Country:US
Mailing Address - Phone:626-914-4587
Mailing Address - Fax:626-914-0881
Practice Address - Street 1:410 S GLENDORA AVE
Practice Address - Street 2:SUITE #220
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-6210
Practice Address - Country:US
Practice Address - Phone:626-914-4587
Practice Address - Fax:626-914-0881
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD24268174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist