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Organization

ENDODONTIC & PERIODONTIC ASSOCIATES, LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. J. MICHAEL CVENGROS (COO & PRACTICE ADMINISTRATOR)
(708) 922-1165
Entity
Organization

Contact information

Practice address
18130 HALSTED ST, HOMEWOOD, IL 60430-2507
(708) 799-2550
(708) 799-2568
Mailing address
18130 HALSTED ST, HOMEWOOD, IL 60430-2507
(708) 799-2550
(708) 799-2568

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
060000064
IL
1223P0300X
Periodontics
060000064
IL

Other

Enumeration date
12/05/2006
Last updated
10/17/2014
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