Individual
DR. PHILLIP T MARUCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
801 S PAULINA ST # MC859, CHICAGO, IL 60612-7210
(312) 413-4467
(312) 996-0943
Mailing address
801 S PAULINA ST # MC859, CHICAGO, IL 60612-7210
(312) 413-4467
(312) 996-0943
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
IL
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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