Provider Demographics
NPI:1275706517
Name:PRONSTROLLER, ANTONIO ALANDY (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:ALANDY
Last Name:PRONSTROLLER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 87TH ST
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-3623
Mailing Address - Country:US
Mailing Address - Phone:415-584-2537
Mailing Address - Fax:415-584-0542
Practice Address - Street 1:3100 19TH AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94132-2006
Practice Address - Country:US
Practice Address - Phone:415-584-2537
Practice Address - Fax:415-584-0542
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47779122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist