Individual
ALBERT WILLLIAM TRTANJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1820 DELMAR AVE, GRANITE CITY, IL 62040
(618) 877-4488
(618) 877-4487
Mailing address
1820 DELMAR, GRANITE CITY, IL 62040
(618) 877-4488
(618) 877-4487
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
009647
MO
122300000X
Dentist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004027
—
IL
Enumeration date
02/06/2007
Last updated
07/08/2007
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