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Organization

THEORAL HEALTH INSTITUTE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JASON KORKUS D.D.S. (BOARD MEMBER)
(312) 925-0042
Entity
Organization

Contact information

Practice address
910 SW 15TH ST, DEERFIELD BEACH, FL 33441-6222
(312) 925-0042
Mailing address
678 GREENLEAF AVE, GLENCOE, IL 60022-1765
(312) 925-0042

Taxonomy

Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
DN20850
FL

Other

Enumeration date
11/16/2015
Last updated
11/16/2015
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