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Organization

MARTHA E. DIAZ D.D.S., P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EUGENIO SIERRA MBA (ADMINISTRATOR)
(847) 599-3855
Entity
Organization

Contact information

Practice address
2634 GRAND AVE, SUITE 207, WAUKEGAN, IL 60085-2458
(847) 599-3855
(847) 599-3859
Mailing address
2634 GRAND AVE, SUITE 207, WAUKEGAN, IL 60085-2458
(847) 599-3855
(847) 599-3859

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
IL

Other

Enumeration date
03/20/2008
Last updated
03/20/2008
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