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Organization
TINYTOOTHPA LTD
Active
Organization
TINYTOOTHPA LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGELO PANOS (SECRETARY)
(847) 256-2501
Entity
Organization
Contact information
Practice address
1103 CENTRAL AVE, WILMETTE, IL 60091-2611
(847) 256-2501
(948) 256-2508
Mailing address
1103 CENTRAL AVE, WILMETTE, IL 60091-2611
(847) 256-2501
(948) 256-2508
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019023432
IL
Other
Enumeration date
04/27/2016
Last updated
04/27/2016
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