DR. Ernest L Dietl JR.

NPI #1871535963 in Park Forest, Illinois

Provider Information

NPI Number: 1871535963
Entity Type: Individual
Name: DR. Ernest L Dietl JR.
Gender: Not Specified
Sole Proprietor: Not Answered
Primary Specialty: Dentist
Enumeration Date: Jun 12, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 5 CENTRE ST
Address 2: SUITE 1
City: Park Forest
State: Illinois
ZIP Code: 60466-2001
Phone: (708) 748-2800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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