Provider Demographics
NPI:1295185734
Name:DAY, ANTINIA
Entity Type:Individual
Prefix:
First Name:ANTINIA
Middle Name:
Last Name:DAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:577 STERNBERG AVE
Mailing Address - Street 2:USA DENTAL ACTIVITY HEADQUARTERS
Mailing Address - City:FORT EUSTIS
Mailing Address - State:VA
Mailing Address - Zip Code:23604-1526
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2601 C AVE
Practice Address - Street 2:BUILDING 8204
Practice Address - City:FORT LEE
Practice Address - State:VA
Practice Address - Zip Code:23801-1717
Practice Address - Country:US
Practice Address - Phone:804-734-9608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist