Dr. Jason Clay Antonio, D.D.S.
Dentist in Moreno Valley, CA. Individual provider (NPI-1).
NPI number1245554153
StatusActive
Last updated in NPPESMar 22, 2010
Details
- NPI
- 1245554153
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jason Clay Antonio
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 22, 2010
- Last updated
- Mar 22, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 59169 | CA | Yes |
Practice location
11875 Pigeon Pass RdMoreno Valley, CA 92557-6039
Phone 951-488-8868
Mailing address
609 Amaranta AvePerris, CA 92571-7803
Phone 951-544-5535
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All 62 Dentist providers in Moreno Valley · All 3,435 providers in Moreno Valley
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