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1285826420
JASON P THEOBALD
GREAT LAKES, IL
NPI
1285826420
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: IL 019027355)
Enumeration Date
2007-08-13
Last Update Date
2007-10-10
Business Address
Dr. JASON P THEOBALD DDS
3001 6TH ST STE A
GREAT LAKES, IL 60088
Phone number: 847-688-2100
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Mailing Address
Dr. JASON P THEOBALD DDS
3001 6TH ST STE A
GREAT LAKES, IL 60088
Phone number:
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