# RITA M. ANTOLIN DDS A PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598156119
- **Authorized official:** MRS. RITA MARIANO ANTOLIN (DDS)
- **Authorized official phone:** (818) 703-1299

## Contact information

- **Practice address:** 21301A SATICOY STREET, CANOGA PARK, CA 91304
- **Practice address phone:** (818) 703-1299
- **Mailing address:** 21301A SATICOY STREET, CANOGA PARK, CA 91304
- **Mailing address phone:** (818) 703-1299

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 49053 | CA | Yes |

## Other

- **Enumeration date:** 02/18/2015
- **Last updated:** 02/18/2015