EDWARD GERONIMO VIVIT

CHICAGO, IL
NPI1174663561
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: IL  019022192)
Enumeration Date2007-02-07
Last Update Date2007-07-08
Business Address
Dr. EDWARD GERONIMO VIVIT DDS
3338 W MONTROSE AVE
CHICAGO, IL 60618-1247
Phone number: 773-478-9393
Mailing Address
Dr. EDWARD GERONIMO VIVIT DDS
3338 W MONTROSE AVE
CHICAGO, IL 60618-1247
Phone number: 773-478-9393