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1073733275
PATRICK MICHEAL CUSACK
PEORIA, IL
NPI
1073733275
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics
(Licence: IL 019 024413)
Enumeration Date
2007-04-27
Last Update Date
2007-07-08
Business Address
Dr. PATRICK MICHEAL CUSACK DMD,MSD
1324 W. NORTHMOOR RD.
PEORIA, IL 61614
Phone number: 309-693-3200
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Mailing Address
Dr. PATRICK MICHEAL CUSACK DMD,MSD
1324 W NORTHMOOR RD
PEORIA, IL 61614-3470
Phone number: 309-693-3200
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