Organization
CHARLES J. ANTONINI, DDS, MS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES JUBIN ANTONINI DDS,MS (PRESIDENT/OWNER)
(501) 620-4677
Entity
Organization
Contact information
Practice address
200 MCAULEY CT, HOT SPRINGS, AR 71913-6312
(501) 620-4677
Mailing address
200 MCAULEY CT, HOT SPRINGS, AR 71913-6312
(501) 620-4677
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
3158
AR
Other
Enumeration date
09/15/2006
Last updated
08/22/2020
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