Provider Demographics
NPI:1336374933
Name:ANTEBI-HADAR, RONIT (DMD, CAGS)
Entity Type:Individual
Prefix:DR
First Name:RONIT
Middle Name:
Last Name:ANTEBI-HADAR
Suffix:
Gender:F
Credentials:DMD, CAGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BOW ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-3003
Mailing Address - Country:US
Mailing Address - Phone:781-860-7700
Mailing Address - Fax:
Practice Address - Street 1:3 BOW ST
Practice Address - Street 2:SUITE 2
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-3003
Practice Address - Country:US
Practice Address - Phone:781-860-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18551041223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry