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1760904171
TIMOTHY JOHN LONGO
CHICAGO, IL
NPI
1760904171
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: IL 019.031249)
Enumeration Date
2017-07-07
Last Update Date
2017-07-07
Business Address
Dr. TIMOTHY JOHN LONGO DDS
4039 W NORTH AVE
CHICAGO, IL 60639-5219
Phone number: 773-782-4800
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Mailing Address
Dr. TIMOTHY JOHN LONGO DDS
350 N CLARK STREET STE 600 C/O KOS SERVICES, ATTN: HR
CHICAGO, IL 60654-4782
Phone number:
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