Organization
RICHARD ANTHONY, DDS MS, A PROF. CORP.
Active
Other names
Blackhawk Orthodontics, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD J ANTHONY D.D.S., M.S. (PRESIDENT)
(925) 736-3311
Entity
Organization
Contact information
Practice address
4165 BLACKHAWK PLAZA CIR, SUITE 260, DANVILLE, CA 94506-4904
(925) 736-3311
(925) 736-3313
Mailing address
4165 BLACKHAWK PLAZA CIR, SUITE 260, DANVILLE, CA 94506-4904
(925) 736-3311
(925) 736-3313
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
34025
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180515
CIGNA PROVIDER NUMBER
CA
Enumeration date
09/20/2006
Last updated
08/22/2020
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