| NPI | 1811362791 |
|---|---|
| Doing Business As | THE DENTAL OFFICE AT MELROSE PARK |
| Entity Type | Organization |
| Authorized Contact | THEODORE HARRY DIMOULIS Owner/Dentist 847-651-2692 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IL 019.030253) |
| Additional Taxonomies | 1223P0300X Dentist Periodontics |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| Enumeration Date | 2015-12-03 |
| Last Update Date | 2015-12-03 |