Individual
DR. ANTHONY E DEZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
23080 ALESSANDRO BLVD STE 201, MORENO VALLEY, CA 92553-9674
(951) 697-0909
Mailing address
18306 BERRY RD, RIVERSIDE, CA 92508-8869
(951) 452-0089
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
106894
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106894
—
CA
Enumeration date
09/02/2021
Last updated
09/02/2021
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