Edp of Illinois P.c
NPI #1154712784 in Dupo, Illinois
Provider Information
- NPI Number
- 1154712784
- Entity Type
- Organization
- Organization Name
- Edp of Illinois P.c
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Feb 18, 2015
- Last Updated
- Sep 29, 2021
Practice Location
Authorized Official
- Name
- MELISSA GARIBAY
- Title
- CREDENTIALING MANAGER
- Phone
- (312) 736-8963
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery |
| Clinic/Center - Dental — Dental |
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