Provider Demographics
NPI:1356476428
Name:ANTON, JOHN FRANK (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:FRANK
Last Name:ANTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1316 JACKIE RD SE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-6618
Mailing Address - Country:US
Mailing Address - Phone:505-994-9693
Mailing Address - Fax:505-891-3169
Practice Address - Street 1:1316 JACKIE RD.
Practice Address - Street 2:SUITE 300
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-3741
Practice Address - Country:US
Practice Address - Phone:505-994-9693
Practice Address - Fax:505-891-3169
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD14981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice