John William Polivka, D.D.S.

NPI #1891126454 in La Grange Highlands, Illinois

Provider Information

NPI Number: 1891126454
Entity Type: Individual
Name: John William Polivka, D.D.S.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: Dec 9, 2013
Last Updated: Dec 9, 2013

Practice Location

Address: 11000 JANN CT
City: La Grange Highlands
State: Illinois
ZIP Code: 60525-7308
Phone: (708) 699-6659

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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