Individual
DR. ANTHONY MARTIN CARBONELLA IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
30 QUAKER FARMS RD, SOUTHBURY, CT 06488-2732
(203) 580-4867
Mailing address
3 WINTER RIDGE RD, SANDY HOOK, CT 06482-1099
(752) 799-8644
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
22DI 02589400
NJ
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
13283
CT
Other
Enumeration date
07/19/2011
Last updated
04/05/2023
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