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Organization
PATRICIA CRISOSTOMO DMD PC
Active
Organization
PATRICIA CRISOSTOMO DMD PC
Active
Other names
Lawrence-Ashland Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICIA BETTINA CRISOSTOMO D.M.D. (DENTIST)
(773) 271-7910
Entity
Organization
Contact information
Practice address
1732 W LAWRENCE AVE, CHICAGO, IL 60640-4412
(773) 271-7910
(773) 271-7912
Mailing address
P.O. BOX 408080, CHICAGO, IL 60640-9998
(773) 271-7910
(773) 271-7912
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019025133
IL
Other
Enumeration date
12/16/2008
Last updated
11/02/2009
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