Individual
DEMETRIOS DIAMANTAKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS PC
Contact information
Practice address
96 W MORELAND AVE, ADDISON, IL 60101
(630) 543-7180
(630) 543-9803
Mailing address
96 W MORELAND AVE, ADDISON, IL 60101
(630) 543-7180
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019 23698
IL
Other
Enumeration date
12/04/2006
Last updated
07/08/2007
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