MEDICARE: DR. HALIM ANTONIO INA JR. D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0700X	Prosthodontics	20803	OH

General Provider Information

NPI Number	:	1760621601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HALIM ANTONIO INA JR. D.D.S.

Provider Business Mailing Address
First Line	:	544 WHITE POND DR
Second Line	:	SUITE D
City	:	AKRON
State	:	OH
Zip	:	44320-1141
Country	:	US
Telephone Number	:	330-869-8100
Fax Number	:	330-869-8156

Provider Business Practice Location Address
First Line	:	544 WHITE POND DR
Second Line	:	SUITE D
City	:	AKRON
State	:	OH
Zip	:	44320-1141
Country	:	US
Telephone Number	:	330-869-8100
Fax Number	:	330-869-8156

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2009
Last Update Date	:	02/17/2009

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