Organization
JACK S. LITZ, D.D.S., LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK S. LITZ D.D.S. (PRESIDENT)
(773) 735-2515
Entity
Organization
Contact information
Practice address
6435 S PULASKI RD, CHICAGO, IL 60629-5148
(773) 735-2515
Mailing address
6435 S PULASKI RD, CHICAGO, IL 60629-5148
(773) 735-2515
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
01912745
IN
Other
Enumeration date
10/04/2010
Last updated
10/04/2010
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