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Individual

DR. MISHA JANE IVETICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
4084 SOUTHWEST HWY, HOMETOWN, IL 60456-1100
(708) 424-8110
(708) 425-3878
Mailing address
211 EAST OHIO, #906, CHICAGO, IL 60611-7200
(312) 222-1955

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
IL

Other

Enumeration date
04/04/2007
Last updated
07/08/2007
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