THEODORE LEE MOSS

STERLING, IL
NPI1366598526
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223X0400X Dentist Orthodontics and Dentofacial Orthopedics
(Licence: IL  1915769)
Enumeration Date2007-01-28
Last Update Date2007-07-08
Business Address
DR. THEODORE LEE MOSS D.M.D.
804 FREEPORT RD
STERLING, IL 61081-3028
Phone number: 815-625-3504
Mailing Address
DR. THEODORE LEE MOSS D.M.D.
677 FOREST HILL RD
LAKE FOREST, IL 60045-3127
Phone number: 847-295-7581
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