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Organization
R.A. BERQUIST, D.D.S., P.C.
Active
Organization
R.A. BERQUIST, D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT ALLEN BERQUIST D.D.S. (OWNER/DENTIST)
(708) 799-4488
Entity
Organization
Contact information
Practice address
19710 GOVERNORS HWY, SUITE #4, FLOSSMOOR, IL 60422-2080
(708) 799-4488
(708) 799-7956
Mailing address
19710 GOVERNORS HWY, SUITE #4, FLOSSMOOR, IL 60422-2080
(708) 799-4488
(708) 799-7956
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19-011929
IL
Other
Enumeration date
03/10/2011
Last updated
03/10/2011
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