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Organization

VALLEY CREEK FAMILY DENTAL LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PATRICK MICHAEL MITSOS DMD (PRESIDENT)
(708) 954-7396
Entity
Organization

Contact information

Practice address
11244 W LAPORTE RD, MOKENA, IL 60448
(708) 479-2203
(708) 479-2412
Mailing address
11244 W LAPORTE RD, MOKENA, IL 60448
(708) 479-2203

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019029811
IL

Other

Enumeration date
07/20/2017
Last updated
03/17/2018
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