Individual
DR. LISA ANNE ANTONELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
330 PLANTATION STREET, WORCESTER, MA 01604
(508) 753-1911
(508) 753-1837
Mailing address
330 PLANTATION STREET, WORCESTER, MA 01604
(508) 753-1911
(508) 753-1837
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
16204
MA
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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