Individual
DR. ANTHONY GEORGE PAVONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S. M.D.
Contact information
Practice address
2 MEDICAL PARK DR STE 6, WEST NYACK, NY 10994-1966
(845) 675-8008
(845) 675-8010
Mailing address
2 MEDICAL PARK DR STE 6, WEST NYACK, NY 10994-1966
(845) 675-8008
(845) 675-8010
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0491391
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0491391
DENTAL LICENSE
NY
01
—
2366611
MEDICAL LICENSE
NY
Enumeration date
10/05/2006
Last updated
02/25/2021
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