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Individual

DR. JOSEPH BAJTNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1718
(847) 570-2461
Mailing address
8830 LOWELL TER, SKOKIE, IL 60076-1840
(847) 946-7146

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
018001906
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
018001906
ILLINOIS DENTAL TEMPORARY TRAINING LICENSE
IL
Enumeration date
06/03/2014
Last updated
06/03/2014
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