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Organization
ZAVALA DENTISTRY PC
Active
Organization
ZAVALA DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSE ZAVALA DDS (DENTIST)
(815) 534-0563
Entity
Organization
Contact information
Practice address
4939 W 14TH ST, CICERO, IL 60804-1419
(708) 652-1080
Mailing address
4939 W 14TH ST, CICERO, IL 60804-1419
(708) 652-1080
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019027256
IL
Other
Enumeration date
04/22/2015
Last updated
04/22/2015
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