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Organization
RIVER FOREST DENTAL STUDIO
Active
Organization
RIVER FOREST DENTAL STUDIO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GINA MARIE PICCIONI (DMD)
(708) 366-6760
Entity
Organization
Contact information
Practice address
7700 MADISON ST, RIVER FOREST, IL 60305-2102
(708) 366-6760
(708) 366-6762
Mailing address
7700 MADISON ST, RIVER FOREST, IL 60305-2102
(708) 366-6760
(708) 366-6762
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019023349
IL
Other
Enumeration date
12/07/2012
Last updated
12/10/2012
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