Individual
DR. ANTHONY A. INDOVINA SR.
Active
Individual
DR. ANTHONY A. INDOVINA SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2650
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110423
CIGNA DMO
LA
05
—
1826502
—
LA
01
—
4013264
AETNA EPO
LA
01
—
600034
UNITED CONCORDIA
LA
01
—
689358
AETNA HMO
LA
01
—
A1577
BLUE CROSS FEDERAL
LA
Enumeration date
12/19/2006
Last updated
07/09/2007
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