Individual
DR. JOHN E. ANTONIO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
6349 U.S. HIGHWAY 550, CUB, NM 87013
(575) 289-3291
Mailing address
2108 REX CT NE, ALBUQUERQUE, NM 87112-3661
(505) 440-4498
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD3776
NM
Other
Enumeration date
11/19/2012
Last updated
11/19/2012
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