Provider Demographics
NPI:1750006094
Name:REJON, MARIA ANTONIETA (DMD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ANTONIETA
Last Name:REJON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 RANGEWAY RD UNIT 6211
Mailing Address - Street 2:
Mailing Address - City:NORTH BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01862-2057
Mailing Address - Country:US
Mailing Address - Phone:754-204-6371
Mailing Address - Fax:
Practice Address - Street 1:71 ROUTE 101A STE 8
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031-2274
Practice Address - Country:US
Practice Address - Phone:603-672-6546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH047791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice