Individual
JOHNNY NICO ATENCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
300 TUSKEGEE BLVD, DOVER AFB, DE 19902-5003
(302) 730-4633
Mailing address
300 TUSKEGEE BLVD, DOVER AFB, DE 19902-5003
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN.00205615
CO
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
04/18/2023
Last updated
07/29/2024
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