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1578952065
GERALD
LIBERTYVILLE, IL
NPI
1578952065
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Entity Type
Organization
Authorized Contact
GERALD A DISMER
Owner
847-902-8305
Organization Subpart ?
No
Primary Taxonomy
261QD0000X Clinic/Center, Dental
(Licence: IL 019015751)
Enumeration Date
2015-01-21
Last Update Date
2015-01-21
Business Address
GERALD
1016 MICHAELS LN
LIBERTYVILLE, IL 60048-3715
Phone number: 847-902-8305
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Mailing Address
GERALD
1016 MICHAELS LN
LIBERTYVILLE, IL 60048-3715
Phone number: 847-902-8305
Copy
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