Johnny Nico Atencio, BS
Dentist in Dover Afb, DE. Individual provider (NPI-1).
NPI number1942997176
StatusActive
Last updated in NPPESJul 29, 2024
Details
- NPI
- 1942997176
- Entity type
- Individual (NPI-1)
- Name
- Johnny Nico Atencio
- Credential
- BS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 18, 2023
- Certification date
- Jul 29, 2024
- Last updated
- Jul 29, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | DEN.00205615 | CO | Yes |
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – |
Practice location
300 Tuskegee BlvdDover Afb, DE 19902-5003
Phone 302-730-4633
Mailing address
300 Tuskegee BlvdDover Afb, DE 19902-5003
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