Provider Demographics
NPI:1487690087
Name:ANTON, ANGELA DUFFIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:DUFFIN
Last Name:ANTON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 WILSON RD
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-3922
Mailing Address - Country:US
Mailing Address - Phone:281-446-7353
Mailing Address - Fax:281-446-0789
Practice Address - Street 1:90 WILSON RD
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-3922
Practice Address - Country:US
Practice Address - Phone:281-446-7353
Practice Address - Fax:281-446-0789
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice