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Individual

ANDREY ANTONENKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
10 SIERRA GATE PLZ STE 190, ROSEVILLE, CA 95678-6647
(916) 786-3303
Mailing address
10 SIERRA GATE PLZ STE 190, ROSEVILLE, CA 95678-6647
(916) 786-3303

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
100314
CA

Other

Enumeration date
07/06/2016
Last updated
11/06/2020
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