Organization
THOMAS W. PISSIOS DDS, LTD
Active
Other names
Edison Park Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS W. PISSIOS DDS (PRESIDENT)
(773) 792-3200
Entity
Organization
Contact information
Practice address
6780 N NORTHWEST HWY, CHICAGO, IL 60631-1242
(773) 792-3200
(773) 792-3233
Mailing address
6780 N NORTHWEST HWY, CHICAGO, IL 60631-1242
(773) 792-3200
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/18/2021
Last updated
06/18/2021
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