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1083708648
BRIAN R DEGISE
PEORIA, IL
NPI
1083708648
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics
(Licence: IL 021-001599)
Enumeration Date
2006-10-03
Last Update Date
2007-07-08
Business Address
Dr. BRIAN R DEGISE DDS, PC
1318 W CANDLETREE DR
PEORIA, IL 61614-1586
Phone number: 309-691-9171
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Mailing Address
Dr. BRIAN R DEGISE DDS, PC
1318 W CANDLETREE DR
PEORIA, IL 61614-1586
Phone number: 309-691-9171
Copy
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