Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 019025251 | IL |
NPI | 1114931821 |
---|---|
Provider Name | Dr. Anthony Joseph Montella |
First Address | Westlake Village, CA 91361-2699 |
Second Address | Westlake Village, CA 91361-2699 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 06/08/2014 |