Individual
KYLIE ANTOLINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
3056 NE HOLLADAY ST APT 501, PORTLAND, OR 97232-2491
(831) 421-2418
Mailing address
3056 NE HOLLADAY ST APT 501, PORTLAND, OR 97232-2491
(831) 421-2418
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H6343
OR
Other
Enumeration date
12/21/2012
Last updated
12/21/2012
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