Individual
RONALD ANGELO CANNIZZARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
545 RIDGEMOOR DRIVE, WILLOWBROOK, IL 60527
(630) 654-1869
(708) 255-5524
Mailing address
545 RIDGEMOOR DRIVE, WILLOWBROOK, IL 60527
(630) 654-1869
(708) 255-5524
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019014811
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
021000899
IL
Other
Enumeration date
12/15/2006
Last updated
04/07/2020
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