ALAN ROY ANTAO

DOVER AFB, DE
NPI1841592235
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: FL  DN21372)
Additional Taxonomies363A00000X Physician Assistant
Enumeration Date2010-11-17
Last Update Date2016-11-02
Business Address
-- ALAN ROY ANTAO PA-C, DMD
300 TUSKEGEE BLVD BUILDING 304
DOVER AFB, DE 19902-5003
Phone number: 302-677-2227
Mailing Address
-- ALAN ROY ANTAO PA-C, DMD
3136 WOODFIELD DR
KOKOMO, IN 46902-4788
Phone number: 765-513-5700
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