# STEPHEN T JAGIELO DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841581436
- **Authorized official:** DR. STEPHEN T JAGIELO DDS (PRESIDENT)
- **Authorized official phone:** (630) 969-4441

## Contact information

- **Practice address:** 4913 MAIN ST, DOWNERS GROVE, IL 60515-3612
- **Practice address phone:** (630) 969-4441
- **Practice address fax:** (630) 969-4480
- **Mailing address:** 4913 MAIN ST, DOWNERS GROVE, IL 60515-3612
- **Mailing address phone:** (630) 969-4441
- **Mailing address fax:** (630) 969-4480

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 021-001523 | IL | Yes |

## Other

- **Enumeration date:** 04/29/2011
- **Last updated:** 04/29/2011