Martha E. Diaz D.d.s., P.c.

NPI #1043481765 in Waukegan, Illinois

Provider Information

NPI Number
1043481765
Entity Type
Organization
Organization Name
Martha E. Diaz D.d.s., P.c.
Primary Specialty
Preferred Provider Organization
Enumeration Date
Mar 20, 2008
Last Updated
Mar 20, 2008

Practice Location

Address
2634 GRAND AVE
Address 2
SUITE 207
ZIP Code
60085-2458
Phone
(847) 599-3855

Authorized Official

Name
EUGENIO SIERRA, MBA
Title
ADMINISTRATOR
Phone
(847) 599-3855

Specialties & Taxonomy Codes

Specialty
Preferred Provider Organization

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