Organization
JOHN J DZAKOVICH DDS LTD
Active
Other names
Maywood Family Dental ltd
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES POULOS DDS (PRESIDENT)
(708) 865-2225
Entity
Organization
Contact information
Practice address
1409 S 5TH AVE, MAYWOOD, IL 60153-2128
(708) 865-2225
Mailing address
1409 S 5TH AVE, MAYWOOD, IL 60153-2128
(708) 865-2225
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
019.016695
IL
Other
Enumeration date
10/15/2014
Last updated
10/15/2014
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