Provider Demographics
NPI:1396700878
Name:ANTOLINI, ANTHONY PAUL (DDS)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:PAUL
Last Name:ANTOLINI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-6663
Mailing Address - Country:US
Mailing Address - Phone:330-394-6660
Mailing Address - Fax:330-394-7422
Practice Address - Street 1:1820 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-6663
Practice Address - Country:US
Practice Address - Phone:330-394-6660
Practice Address - Fax:330-394-7422
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH12403122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist