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1790824167
TIMOTHY JOSEPH BROUDER
MT PROSPECT, IL
NPI
1790824167
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: IL 019.018653)
Enumeration Date
2007-02-05
Last Update Date
2007-07-08
Business Address
Dr. TIMOTHY JOSEPH BROUDER D.D.S.
207 S EMERSON ST
MT PROSPECT, IL 60056-3259
Phone number: 847-577-0199
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Mailing Address
Dr. TIMOTHY JOSEPH BROUDER D.D.S.
207 S EMERSON ST
MT PROSPECT, IL 60056-3259
Phone number:
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