Individual
JODI ANN ANTONACCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
2918 W 10TH ST STE 1, GREELEY, CO 80634-5457
(970) 301-1364
Mailing address
2918 W 10TH ST STE 1, GREELEY, CO 80634-5457
(970) 673-8411
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
905787
CO
Other
Enumeration date
06/25/2019
Last updated
06/25/2019
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