Mauricio Antezana

NPI #1063876399 in Atlantis, Florida

Provider Information

NPI Number: 1063876399
Entity Type: Individual
Name: Mauricio Antezana
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Enumeration Date: Apr 12, 2016
Last Updated: Jul 21, 2022

Practice Location

Address: 115 JOHN F KENNEDY DR
City: Atlantis
State: Florida
ZIP Code: 33462-1152
Phone: (561) 967-3513

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X
Dentist	122300000X	Primary

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