DR. Misha Jane Ivetich, DDS

NPI #1154443919 in Hometown, Illinois

Provider Information

NPI Number: 1154443919
Entity Type: Individual
Name: DR. Misha Jane Ivetich, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Apr 4, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 4084 SOUTHWEST HWY
City: Hometown
State: Illinois
ZIP Code: 60456-1100
Phone: (708) 424-8110

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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