Provider Demographics
NPI:1144835059
Name:ANTHONY, CHELSEA (DDS)
Entity type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23207 NORCREST DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-2586
Mailing Address - Country:US
Mailing Address - Phone:231-233-0340
Mailing Address - Fax:
Practice Address - Street 1:23800 GREATER MACK AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-1406
Practice Address - Country:US
Practice Address - Phone:586-775-6320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901600721122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist