Patrick Mitsos

NPI #1558775122 in Rockford, Illinois

Provider Information

NPI Number: 1558775122
Entity Type: Individual
Name: Patrick Mitsos
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 11, 2014
Last Updated: Jun 11, 2014

Practice Location

Address: 5819 E RIVERSIDE BLVD # 21
City: Rockford
State: Illinois
ZIP Code: 61114-4963
Phone: (815) 282-4311

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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