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Organization
VALLEY CREEK FAMILY DENTAL LTD
Active
Organization
VALLEY CREEK FAMILY DENTAL LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK MICHAEL MITSOS DMD (PRESIDENT)
(708) 954-7396
Entity
Organization
Contact information
Practice address
11244 W LAPORTE RD, MOKENA, IL 60448
(708) 479-2203
(708) 479-2412
Mailing address
11244 W LAPORTE RD, MOKENA, IL 60448
(708) 479-2203
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019029811
IL
Other
Enumeration date
07/20/2017
Last updated
03/17/2018
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