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Individual

DR. ANTON ALEXANDRE DIY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
1509 AVENUE G, COUNCIL BLUFFS, IA 51501-2516
(712) 325-1544
Mailing address
210 S 16TH ST APT 512, OMAHA, NE 68102-1623
(310) 749-2349

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DDS-09105
IA

Other

Enumeration date
07/07/2014
Last updated
07/07/2014
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