| NPI | 1386098390 |
|---|---|
| Former Legal Business Name | PERIODONTAL MEDICINE AND SURGICAL SPECIALISTS, LTD |
| Entity Type | Organization |
| Authorized Contact | GEORGE MANDELARIS President 630-627-3930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IL 021001938) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| 1223P0300X Dentist, Periodontics (Licence: IL 021002676) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 021002351) | |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2016-12-23 |