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JOHN BRESCIA DDS

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1609233782

Individual Registrant:
 JOHN  BRESCIA DDS
Gender: M
Sole Proprietor

Location and contact information for practice:
7411 LAKE ST STE L-100 RIVER FOREST, IL 60305-1876 US
Tel: 708-366-0424  Fax: --

Contact information for business:
7411 LAKE ST STE L-100 RIVER FOREST, IL 60305-1876 US
Tel: 708-366-0424  Fax: --

Registration Information:
NPI: 1609233782
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
IL01916649

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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