Organization
ANTONOFF DENTAL, LLC
Active
Other names
Modern Family Dentists
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH ANTONOFF (DENTISTS)
(414) 698-4324
Entity
Organization
Contact information
Practice address
6803 SHERIDAN RD, KENOSHA, WI 53143-1321
(262) 484-4356
Mailing address
6803 SHERIDAN RD, KENOSHA, WI 53143-1321
(262) 484-4356
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/13/2022
Last updated
10/13/2022
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