Provider Demographics
NPI:1629484076
Name:ANTAL, DANIELLE (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:
Last Name:ANTAL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3227 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-3328
Mailing Address - Country:US
Mailing Address - Phone:805-681-7356
Mailing Address - Fax:
Practice Address - Street 1:3227 STATE ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3328
Practice Address - Country:US
Practice Address - Phone:805-681-7356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-07
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL206151223X0400X
CA1043281223X0400X
FLDN 20615122300000X
CODEN.002037931223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL20615OtherFL LICENSE DN#