JASON P THEOBALD

GREAT LAKES, IL
NPI1285826420
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: IL  019027355)
Enumeration Date2007-08-13
Last Update Date2007-10-10
Business Address
Dr. JASON P THEOBALD DDS
3001 6TH ST STE A
GREAT LAKES, IL 60088
Phone number: 847-688-2100
Mailing Address
Dr. JASON P THEOBALD DDS
3001 6TH ST STE A
GREAT LAKES, IL 60088
Phone number: