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JOHN ANTONELLI DDS

>> Dentist >> Dental Providers

Registrant NPI Number: 1316096977

Individual Registrant:
 JOHN  ANTONELLI DDS
Gender: M
Not Sole Proprietor

Location and contact information for practice:
3200 S UNIVERSITY DRIVE NOVA SOUTHEASTERN UNIVERSITY COLLEGE OF DENTAL MEDICINE FORT LAUDERDALE DAVIE, FL 33328-2018 US
Tel: 954-262-7348  Fax: --

Contact information for business:
3200 S UNIVERSITY DRIVE NOVA SOUTHEASTERN UNIVERSITY COLLEGE OF DENTAL MEDICINE FORT LAUDERDALE DAVIE, FL 33328-2018 US
Tel: 954-262-7348  Fax: --

Registration Information:
NPI: 1316096977
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
FLTPNU053

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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