Anthony Frank Vinciguerra, DDS

Individual provider Active NPI Pediatric Dentistry · Nehalem, OR

NPI 1982168506 · NPPES record last updated Jan 28, 2019

Key facts

NPI
1982168506
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Dentistry 1223P0221X
License
DEN11518 (MA)
Practice address
37315 Second St
Nehalem, OR 97131-9679
Phone
(508) 878-3537
NPI assigned
Jan 28, 2019
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DEN11518MAMDPediatric Dentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DEN11518 MA Yes

Addresses

Primary practice location

37315 Second St
Nehalem, OR 97131-9679

Mailing address

37315 Second St
Nehalem, OR 97131-9679
Phone (508) 878-3537

Other providers in Nehalem, OR

All providers in Nehalem, OR · Pediatric Dentistry in Oregon

Sources for this page

Verify at the official NPI Registry.