Organization
GEORGE S. PANOS D.D.S. LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE S. PANOS D.D.S. (PRESIDENT)
(630) 650-2428
Entity
Organization
Contact information
Practice address
5470 W MADISON ST, CHICAGO, IL 60644-4031
(773) 287-2277
Mailing address
PO BOX 651, CARPENTERSVILLE, IL 60110-0651
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
019022207
IL
Other
Enumeration date
04/04/2011
Last updated
04/04/2011
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