JASON C PRIMAVERA

CHICAGO, IL
NPI1831487370
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: IL  018001817)
Enumeration Date2011-07-19
Last Update Date2015-08-24
Business Address
Dr. JASON C PRIMAVERA D.D.S.
1901 W HARRISON ST
CHICAGO, IL 60612-3714
Phone number: 801-358-8697
Mailing Address
Dr. JASON C PRIMAVERA D.D.S.
6050 BRYNWOOD DR
ROCKFORD, IL 61114-6579
Phone number: 815-877-0694