Individual
DR. KENNETH ANTONELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5788 RIDGE RD, PARMA, OH 44129-3168
(440) 886-4100
(512) 498-0288
Mailing address
5788 RIDGE RD, PARMA, OH 44129-3168
(440) 886-4100
(512) 498-0288
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17771
OH
Other
Enumeration date
01/30/2007
Last updated
07/08/2007
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